Nair Sukumaran Pradeep
Department of Dermatology and Venereology, Government Medical College, Trivandrum, Kerala, India.
Indian Dermatol Online J. 2018 Jan-Feb;9(1):33-36. doi: 10.4103/idoj.IDOJ_116_17.
Multidrug therapy (MDT) in leprosy has brought the prevalence of leprosy to elimination levels. However, these drugs are not without toxicity. The primary aim of this study was to find the prevalence of adverse drug reactions (ADR) to MDT and the secondary aim to study the clinical features of these drug reactions.
This is a19-year retrospective descriptive study of all new leprosy cases with ADR to MDT, requiring a change in regime.
There were 901 new leprosy cases in the study period. There were 28 cases of documented ADR to MDT necessitating a change in regime, thus accounting for a prevalence of 3.11%. There were 24 males (85.71%) and 4 females (14.29%) with a male/female ratio 6:1. Mean age was 39.58 years. Borderline tuberculoid was the commonest type of leprosy in which ADR were seen (46.43%). Dapsone was the commonest drug to cause ADR seen in 17 cases (60.71%). Hepatic involvement in the form of drug-induced hepatitis was the commonest presentation of ADR in this study accounting for 13 cases (46.43%), followed by skin rash, 9 cases (32.14%). There were no ADR reported to clofazimine. No ADR was reported to the alternative regimes given.
The prevalence of ADRs was low in this study, with dapsone being the commonest drug. There were no adverse reactions to clofazimine. No adverse reactions were reported with the alternative regimes of ofloxacin and minocycline.
麻风病的多药联合治疗(MDT)已使麻风病患病率降至消除水平。然而,这些药物并非没有毒性。本研究的主要目的是确定MDT药物不良反应(ADR)的患病率,次要目的是研究这些药物反应的临床特征。
这是一项对所有因MDT发生ADR而需要改变治疗方案的新麻风病病例进行的19年回顾性描述性研究。
研究期间共有901例新麻风病病例。有28例记录在案的MDT所致ADR需要改变治疗方案,患病率为3.11%。男性24例(85.71%),女性4例(14.29%),男女比例为6:1。平均年龄为39.58岁。界线类偏结核型是出现ADR最常见的麻风病类型(46.43%)。氨苯砜是导致ADR最常见的药物,17例(60.71%)。药物性肝炎形式的肝脏受累是本研究中ADR最常见的表现,占13例(46.43%),其次是皮疹,9例(32.14%)。未报告氯法齐明的ADR。也未报告所给予的替代治疗方案的ADR。
本研究中ADR的患病率较低,氨苯砜是最常见的药物。未报告氯法齐明的不良反应。氧氟沙星和米诺环素的替代治疗方案也未报告不良反应。