International open trial of uniform multi-drug therapy regimen for 6 months for all types of leprosy patients: rationale, design and preliminary results.
OBJECTIVE
To describe the rationale, design and preliminary results of an open trial of 6 months uniform multi-drug therapy (U-MDT) for all types of leprosy patients assuming a cumulative relapse rate not exceeding 5% over 5 years of follow-up.


METHODS
We intended to recruit 2500 patients each in multi-bacillary (MB) and pauci-bacillary (PB) groups from India (five centres) and China (two centres). Standardized clinical criteria were used to assess skin lesions in the field.


RESULTS
A total of 2912 patients enrolled from November 2003 to May 2007 (India, 2746; China, 166). MB patients constituted 39% and 3% had grade 2 disability. During follow-up, 27 patients (0.9%) developed new lesions. Of these, 78% were on account of reactions. Six patients had clinically confirmed relapse. Clofazimine-related skin pigmentation was short-lived and was acceptable to patients. We analysed data for clinical status of skin lesions. About 2.9% of patients were lost to follow-up; 85.9% completed treatment, of whom 19% had inactive skin lesions. PB patients responded better than MB patients (27%vs. 6%; P < 0.001). At the end of the first (n = 2013) and second year (n = 807) of follow-up post-U-MDT, in 49% and 46% patients, lesions were inactive, respectively (59% and 57% in PB, 37% and 28% in MB; P < 0.001).


CONCLUSIONS
U-MDT appears to be promising with respect to clinical status of skin lesions.
Kroger
Axel
A
UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Switzerland.
Pannikar
V
V
Htoon
M T
MT
Jamesh
A
A
Katoch
K
K
Krishnamurthy
P
P
Ramalingam
K
K
Jianping
Shen
S
Jadhav
Vitthal
V
Gupte
M D
MD
Manickam
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002681:China; D002991:Clofazimine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007194:India; D007917:Leprostatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007918:Leprosy / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D016896:Treatment Outcome
D007917:Leprostatic Agents; D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin