Dupnik Kathryn Margaret, Cardoso Fernando José Ramos, De Macêdo Ana Luiza Braga Brito, De Sousa Igor Leonardo Cardoso, Leite Renata Cristina Barros, Jerônimo Selma Maria Bezerra, Nobre Mauricio Lisboa
Division of Infectious Diseases and Center for Global Health, Weill Cornell Medical College, New York, NY, USA.
Giselda Trigueiro Hospital, Natal, RN, Brazil.
Lepr Rev. 2013 Sep;84(3):209-18.
The objective was to characterise and identify potential risk factors for intolerance to multi-drug leprosy therapy (MDT) which prompted a medication change in a leprosy referral centre in northeastern Brazil.
A retrospective chart review of leprosy patients treated at a state referral centre for leprosy in Natal, Rio Grande do Norte, Brazil was completed. Chart review focus was on adverse effects necessitating modification of MDT regimen.
Six hundred and twelve records were reviewed with detection of 91 (14.8%) adverse effects with associated change in MDT regimen. The most common recorded causes of medication intolerance were anemia (8.7%), headache (4.2%), cyanosis (1.8%), and gastrointestinal symptoms (1-6%). Both female gender (OR = 2.63) and age less than 42 years old (OR = 2.7) remained risk factors for MDT intolerance in a multivariate model including gender, age, and WHO regimen type. With intolerance due to anemia as the outcome, female gender (OR = 2.36) and age less than 42 years (OR = 1.86) were associated.
In this study, female gender and younger age were associated with greater risk of medication intolerance and medication intolerance related to anemia. These findings have important operational implications for drug intolerance monitoring during therapy for leprosy.
本研究旨在对巴西东北部一家麻风病转诊中心因多药联合麻风病治疗（MDT）不耐受而导致用药改变的潜在风险因素进行特征描述和识别。
对巴西北里奥格兰德州纳塔尔市一家州立麻风病转诊中心接受治疗的麻风病患者进行回顾性病历审查。病历审查重点为需要调整MDT方案的不良反应。
共审查了612份记录，发现91例（14.8%）出现不良反应并伴有MDT方案的改变。记录中最常见的药物不耐受原因是贫血（8.7%）、头痛（4.2%）、发绀（1.8%）和胃肠道症状（1 - 6%）。在一个包含性别、年龄和世界卫生组织（WHO）方案类型的多变量模型中，女性（比值比[OR]=2.63）和年龄小于42岁（OR = 2.7）仍然是MDT不耐受的风险因素。以贫血导致的不耐受作为结果，女性（OR = 2.36）和年龄小于42岁（OR = 1.86）与之相关。
在本研究中，女性和较年轻的年龄与更高的药物不耐受风险以及与贫血相关的药物不耐受有关。这些发现对麻风病治疗期间的药物不耐受监测具有重要的实际意义。
