Prevention of repeated episodes of type 2 reaction of leprosy with the use of thalidomide 100 mg/day.
BACKGROUND
Leprosy can have its course interrupted by type 1 and 2 reactional episodes, the last named of erythema nodosum leprosum (ENL). Thalidomide has been the medication of choice for the control of ENL episodes since 1965.


OBJECTIVE
These episodes can repeat and cause damages to the patient. In order to prevent these episodes, an extra dose of 100 mg/day thalidomide was used during six months, followed by a follow-up period of six more months after thalidomide discontinuation.


METHODS
We included 42 patients with multibacillary (MB) leprosy who had episodes of ENL. They were male and female patients aged between 18 and 84 years.


RESULTS
Of the 42 patients, 39 (92.85%) had the lepromatous form and three (7.15%) had the borderline form. We found that 100% of patients had no reactional episode during the use of the drug. During the follow-up period after thalidomide discontinuation, 33 (78.57%) patients had no reactional episode and nine (21.43%), all of them with the lepromatous form, had mild episodes, which were controlled using non-steroidal anti-inflammatory. There were no thalidomide-related side effects.


CONCLUSIONS
A maintenance dose of 100 mg/day of thalidomide showed to be effective to prevent repeated type 2 reactional episodes of ENL.
Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
Maria Stella de Mello Ayres
MS
Putinatti
Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
Joel Carlos
JC
Lastória
Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
Carlos Roberto
CR
Padovani
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D004893:Erythema Nodosum / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage*; D015439:Leprosy, Borderline / Q000188:drug therapy* / Q000517:prevention & control; D015440:Leprosy, Lepromatous / Q000188:drug therapy* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D013792:Thalidomide / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
D007917:Leprostatic Agents; D013792:Thalidomide