Penna Maria Lucia Fernandes, Buhrer-Sékula Samira, Pontes Maria Araci De Andrade, Cruz Rossilene, Gonçalves Heitor De Sá, Penna Gerson Oliveira
Tropical Pathology and Public Health Institute, Federal University of Goias, Goiania, Goias, Brazil.
Lepr Rev. 2012 Sep;83(3):308-19.
Many believe that the regular treatment for multibacillary (MB) leprosy cases could be shortened. A shorter treatment, allowing for uniform treatment for all cases, makes case classification superfluous and therefore simplifies leprosy control.
To evaluate the association of the treatment duration with the frequency of reactions among MB patients.
An open-label randomised clinical trial to compare the present routine treatment with one lasting six months. Patients were recruited between March 2007 and February 2012. We analysed the frequency of first reaction with the Kaplan-Meier method and of recurrent reaction with a Poisson regression, using the treatment group and baciloscopic index level (BI) as independent variables. Logistic regression was used to evaluate the statistical association of different reaction types and the treatment group.
Among those with BI < 3, we found a statistical significant difference of reaction frequencies between the treatment groups from 6 to 18 months since the beginning of treatment. This difference disappears at 2 years after the start of treatment. Multiple reactions were associated with the treatment group and with BI > or = 3. No specific types of reactions were associated with treatment duration.
Although this is the first report of U-MDT/CT-BR, the results presented here support the possibility of use of UMDT in the field.
许多人认为多菌型(MB)麻风病例的常规治疗疗程可以缩短。缩短治疗疗程能实现所有病例的统一治疗,使病例分类变得多余,从而简化麻风病防治工作。
评估治疗疗程与MB患者反应频率之间的关联。
一项开放标签随机临床试验,比较现行常规治疗与为期6个月的治疗。患者于2007年3月至2012年2月招募。我们采用Kaplan-Meier法分析首次反应频率,采用泊松回归分析复发反应频率,将治疗组和细菌指数水平(BI)作为自变量。采用逻辑回归评估不同反应类型与治疗组之间的统计学关联。
在BI<3的患者中,自治疗开始6至18个月时,我们发现治疗组之间的反应频率存在统计学显著差异。治疗开始2年后,这种差异消失。多次反应与治疗组以及BI≥3相关。没有特定类型的反应与治疗疗程相关。
尽管这是关于统一多药联合化疗/缩短疗程方案(U-MDT/CT-BR)的首份报告,但此处呈现的结果支持在现场使用统一多药联合化疗(UMDT)的可能性。