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A Comparative Clinical Trial in Multibacillary Leprosy with Long-Term Relapse Rates of Four Different Multidrug Regimens

2009; American Society of Tropical Medicine and Hygiene; Volume: 81; Issue: 2 Linguagem: Inglês

10.4269/ajtmh.2009.81.330

1476-1645

Tranquilino T. Fajardo, Laarni G. Villahermosa, Fe Eleanor F. Pardillo, Rodolfo M. Abalos, Jasmin Burgos, Eduardo Dela Cruz, R H Gelber,

Mycobacterium research and diagnosis

As a participant in a multicenter trial, we evaluated the relapse rate in 189 multibacillary (MB) leprosy patients treated with four different regimens and followed-up for as many as 12 years after the initiation of treatment. Treatment regimens included 1 year of WHO MDT (a regimen including dapsone, clofazimine, and rifampin), 2 years of WHO MDT, 1 month of daily rifampin and daily ofloxacin, and 1 year of WHO MDT plus an initial 1 month of daily rifampin and daily ofloxacin. Relapse rates after 9 and 12 years from the initiation of therapy in the three regimens that included WHO MDT were 0–3%, whereas relapses occurred in those treated with the 1-month regimen alone at a significantly greater rate ( P < 0.05): 11% at 9 years and 25% at 12 years. Relapses occurred late, beginning at 5 years after the initiation of therapy, and were confined to those patients histopathologically borderline lepromatous and polar lepromatous having a high bacterial burden. Prospects for an alternative effective short-course therapy of leprosy are presented.