Effect of clofazimine on nerve function impairment in pauci-bacillary leprosy patients

Authors

  • Chandrakant B. Poulkar Department of Dermatology, Venereology and Leprosy, Smt. Kashibai Navale Medical College, Pune, Maharashtra; Post Graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi, India
  • Nitin D. Chaudhari Department of Dermatology, Venereology and Leprosy, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India
  • Swapna S. Khatu Department of Dermatology, Venereology and Leprosy, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20185499

Keywords:

Clofazimine, Uniform-MDT, Paucibacillary, Nerve function impairment

Abstract

Background: Clofazimine is a riminophenazine derivative which is useful both for treating the leprosy and managing reactive episodes. Previous studies demonstrated that clofazimine may have a useful prophylactic role against neuritis/type 1 reaction and nerve damage. The WHO Technical Advisory Group (TAG), in its Third meeting in 2002, proposed that uniform MDT regimen (U-MDT) of 6 months duration should be considered to treat all types of leprosy. This study was aimed to determine any additional beneficial effects of clofazimine as part of UMDT in the prevention of nerve function impairment (NFI) in paucibacillary (PB) leprosy patients.

Methods: Sixty paucibacillary leprosy patients were randomized into two groups, A and B consisting of 30 patients each. Group A received U-MDT for 6 months and group B received MDT-PB for 6 months. Nerve function assessment (NFA) using various modalities was done at the beginning (0 month) and at the completion of MDT (6 months) and results were compared.

Results: No statistically significant difference in improvement or deterioration of NFI was found in two groups.

Conclusions: On the basis of present study, we found that addition of clofazimine in standard dose as part of U-MDT has no beneficial role in prevention or improvement of NFI in PB leprosy patients. However, a larger longitudinal study taking substantial number of population in both groups might be helpful to derive any conclusion.

Author Biographies

Chandrakant B. Poulkar, Department of Dermatology, Venereology and Leprosy, Smt. Kashibai Navale Medical College, Pune, Maharashtra; Post Graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi, India

Assistant Professor, Department of dermatology, venereology and leprosy.

Nitin D. Chaudhari, Department of Dermatology, Venereology and Leprosy, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India

Professor, Department of dermatology, venereology and leprosy.

Swapna S. Khatu, Department of Dermatology, Venereology and Leprosy, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India

Associate Professor, Department of dermatology, venereology and leprosy.

References

Saunderson P, Gebre S, Desta K, Byass P, Lockwood DN. The pattern of leprosy related neuropathy in the AMFES patients in Ethiopia: definitions, incidence, risk factors and outcome. Lepr Rev. 2000;71:285–308.

Van Brakel WH, Khawas IB. Silent neuropathy in leprosy: an epidemiological description. Lepr Rev. 1994;65:350-60.

McLeod JG, Hargrave JC, Walsh JC, Booth GC, Gye RS, Barron A. Nerve conduction studies in leprosy. Int J Lepr Other Mycobact Dis. 1975;43:21–31.

Browne SG. B 663 (Geigy)-Further observations on it’s suspected anti-inflammatory action. Lepr Rev. 1966;37:141-5.

Ross WF. Does clofazimine have any any value in the management of reversal reaction? Lepr Rev. 1980;51:92-3.

Arunthathi S, Kumar SK. Does clofazimine have a prophylactic role against neuritis. Lepr Rev. 1997;68:233-41.

World health organization. Report on third meeting of the WHO technical advisory group on elimination of leprosy. WHO/CDS/CPE/CEE/2002-29.

Bell-Krotoski JA. Pocket filaments and specifications for the Semmes – Weinstein monofilaments. J Hand Ther. 1990;3:26-31.

Brandsma JW. Monitoring motor nerves function in leprosy patients. Lepr Rev. 2000;71:258-67.

Porichha D, Rao AK, Nehemaiah E, Mishra MC. Response of thickened nerve trunks and skin lesions of leprosy patients to MDT. Indian J. Lepr. 2011;83(1):31-5.

Bhushan P, Sardana K, Koranne RV, Choudhary M, Manjul P. Diagnosing Multibacillary Leprosy: A comparative evaluation of diagnosing accuracy of slit-skin smear, bacterial index of granuloma and WHO operational classification. Indian J Dermatol Venereol Leprol. 2008;74:322-6.

Koelewijn LF, Meima A, Broekhuis SM, Richardus JH, Mitchell PD, Benbow C, et al. Sensory testing in leprosy: comparison of ballpoint pen and monofilaments. Leprosy Rev. 2003;74(1):42–52.

Khambati FA, Shetty VP, Ghate SD, Capadia GD. Sensitivity and specificity of nerve palpation, monofilament testing and voluntary muscle in detecting peripheral nerve abnormality, using nerve conduction studies as gold standard; A study in 357 patients. Lepr Rev, 2009;80:34-50.

Hackett ER, Shipley DE, Livengood R. Motor nerve conduction velocity studies of ulnar nerve in patients with leprosy. Int J Lepr. 1968;36:282-7.

Kupfer DM, Bronson J, Gilbert WL, Beck J, Gillet J. Differential latency testing: A more sensitive test for radial tunnel syndrome. J Hand Surg. 1998;23:859-64.

Ramkrishnan AG, Srinivasan TM. Electrophysiological correlates of Hanseniasis. Int J Lepr. 1995;63:395-408.

Marques W, Norma T, Foss MD, Arruda AP, Barreira AA. Near nerve potential in lepromatous leprosy. Muscle Nerve. 2003;28:460-3.

Prasad PVS, Babu A, Kaviarasan PK, Viswanathan P, Tippoo R. MDT-MB therapy in PB leprosy, A clinic-pathological assessment. Indian J Dermatol Venereol Leprol. 2005;71:242-5.

Schreuder PA, Naafs B. Chronic recurrent ENL, steroid dependent: long term treatment with high dose clofazimine. Lepr Rev. 2003;74:386-9.

Downloads

Published

2019-01-25

Issue

Section

Original Research Articles