Faust Lena, Klowak Michael, MacRae Cara, Kopalakrishnan Swana, Showler Adrienne J, Boggild Andrea K
5620 McGill International TB Centre, Montreal, QC, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
J Cutan Med Surg. 2021 Jan-Feb;25(1):45-52. doi: 10.1177/1203475420952437. Epub 2020 Sep 1.
Standard dapsone and clofazimine-containing multidrug therapy (MDT) for leprosy is limited by drug tolerability, which poses treatment adherence barriers. Although ofloxacin-based regimens are promising alternatives, current efficacy and safety data are limited, particularly outside of endemic areas. We evaluated treatment outcomes in patients with leprosy receiving ofloxacin-containing MDT (OMDT) at our center.
We performed a retrospective chart review of patients treated for leprosy at our center over an 8-year period (2011-2019). Primary outcomes evaluated were clinical cure rate, occurrence of leprosy reactions, antibiotic-related adverse events, and treatment adherence. Analyses were descriptive; however, data were stratified by age, sex, spectrum of disease, region of origin, and treatment regimen, and odds ratios were reported to assess associations with adverse outcomes.
Over the enrolment period, 26 patients were treated with OMDT ( = 19 multibacillary, = 7 paucibacillary), and none were treated with clofazimine-based standard MDT. At the time of analysis, 23 patients (88%) had completed their course of treatment, and all were clinically cured, while 3 (12%) were still on treatment. Eighteen patients (69%) experienced either ENL ( = 7, 27%), type 1 reactions ( = 7, 27%), or both ( = 4, 15%). No patients stopped ofloxacin due to adverse drug effects, and there were no cases of allergic hypersensitivity, tendinopathy or rupture, or colitis.
We demonstrate a high cure rate and tolerability of OMDT in this small case series over an 8-year period, suggesting its viability as an alternative to standard clofazimine-containing MDT.
含标准氨苯砜和氯法齐明的多药联合疗法(MDT)治疗麻风病受到药物耐受性的限制,这构成了治疗依从性障碍。尽管基于氧氟沙星的治疗方案是有前景的替代方案,但目前的疗效和安全性数据有限,尤其是在流行地区以外。我们评估了在我们中心接受含氧氟沙星多药联合疗法(OMDT)的麻风病患者的治疗结果。
我们对在我们中心8年期间(2011 - 2019年)接受麻风病治疗的患者进行了回顾性病历审查。评估的主要结果是临床治愈率、麻风反应的发生情况、抗生素相关不良事件和治疗依从性。分析采用描述性方法;然而,数据按年龄、性别、疾病谱、原籍地区和治疗方案进行分层,并报告比值比以评估与不良结果的关联。
在入选期间,26例患者接受了OMDT治疗(19例多菌型,7例少菌型),无人接受基于氯法齐明的标准MDT治疗。在分析时,23例患者(88%)完成了治疗疗程,全部临床治愈,而3例(12%)仍在治疗中。18例患者(69%)经历了Ⅱ型麻风反应(7例,27%)、Ⅰ型反应(7例,27%)或两者皆有(4例,15%)。没有患者因药物不良反应而停用氧氟沙星,也没有过敏超敏反应、肌腱病或断裂或伪膜性结肠炎的病例。
在这个为期8年的小病例系列中,我们证明了OMDT具有高治愈率和耐受性,表明其作为含氯法齐明标准MDT替代方案的可行性。