title: Minocycline in leprosy patients with recent onset clinical nerve function impairment.
abstract: Nerve function impairment (NFI) in leprosy may occur and progress despite multidrug therapy alone or in combination with corticosteroids. We observed improvement in neuritis when minocycline was administered in patients with type 2 lepra reaction. This prompted us to investigate the role of minocycline in recent onset NFI, especially in corticosteroid unresponsive leprosy patients. Leprosy patients with recent onset clinical NFI (<6 months), as determined by Monofilament Test (MFT) and Voluntary Muscle Test (VMT), were recruited. Minocycline 100mg/day was given for 3 months to these patients. The primary outcome was the proportion of patients with 'restored,' 'improved,' 'stabilized,' or 'deteriorated' NFI. Secondary outcomes included any improvement in nerve tenderness and pain. In this pilot study, 11 patients were recruited. The progression of NFI was halted in all; with 9 out of 11 patients (81.82%) showing ?restored? or ?improved? sensory or motor nerve functions, on assessment with MFT and VMT. No serious adverse effects due to minocycline were observed. Our pilot study demonstrates the efficacy and safety of minocycline in recent onset NFI in leprosy patients. However, larger and long term comparative trials are needed to validate the efficacy of minocycline in leprosy neuropathy.
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Narang
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.lastname: Arshdeep
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dogra
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007918:Leprosy / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects / Q000627:therapeutic use*; D009043:Motor Activity / Q000187:drug effects; D009046:Motor Neurons / Q000187:drug effects / Q000382:microbiology; D009443:Neuritis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D009460:Neurologic Examination; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D010865:Pilot Projects; D020127:Recovery of Function; D012684:Sensory Thresholds / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007917:Leprostatic Agents; D008911:Minocycline
keywords: leprosy; minocycline; nerve function impairment; neuritis; neuroprotective