Multi-centre, double blind, randomised trial of three steroid regimens in the treatment of type-1 reactions in leprosy

P. S. S. Sundar Rao, D. S. T. Sugamaran, J. Richard, William Cairns Stewart Smith

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: The objective of this randomized trial was to compare three different steroid regimens in treating type I reactions in leprosy in routine clinical practice.

Design: The study design was a multicentre, double-blind, randomized, controlled, parallel group trial in patients with acute reversal reactions. The trial was conducted in six leprosy treatment centres in India. A total of 334 participants with acute type I reaction were recruited to the trial and randomized to one of three prednisolone regimens: high dose (60 mg per day) or low dose (30 mg per day) both tapered over 20 weeks, and short duration (60 mg per day tapered over 12 weeks). The main outcome measure was the proportion of patients failing to respond to treatment and requiring additional steroids.

Results: At the end of 12 months, 46% on the short course required additional steroids compared with 31% on the low dose and 24% on the high dose regimen.

Conclusions: The two 20-week regimens were significantly better than the 12-week regimen. The high dose 20-week regimen was marginally and non-significantly better than the low dose regimen, but the high dose regimen contained 50% more steroid. Reactions in leprosy persist over many months and require long courses of steroids.

Original languageEnglish
Pages (from-to)25-33
Number of pages8
JournalLeprosy Review
Volume77
Publication statusPublished - 2006

Keywords

  • NERVE-FUNCTION IMPAIRMENT
  • DAMAGE
  • CORTICOSTEROIDS
  • PROPHYLAXIS
  • PREVENTION

Cite this

Multi-centre, double blind, randomised trial of three steroid regimens in the treatment of type-1 reactions in leprosy. / Sundar Rao, P. S. S.; Sugamaran, D. S. T.; Richard, J.; Smith, William Cairns Stewart.

In: Leprosy Review, Vol. 77, 2006, p. 25-33.

Research output: Contribution to journalArticle

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abstract = "Objective: The objective of this randomized trial was to compare three different steroid regimens in treating type I reactions in leprosy in routine clinical practice.Design: The study design was a multicentre, double-blind, randomized, controlled, parallel group trial in patients with acute reversal reactions. The trial was conducted in six leprosy treatment centres in India. A total of 334 participants with acute type I reaction were recruited to the trial and randomized to one of three prednisolone regimens: high dose (60 mg per day) or low dose (30 mg per day) both tapered over 20 weeks, and short duration (60 mg per day tapered over 12 weeks). The main outcome measure was the proportion of patients failing to respond to treatment and requiring additional steroids.Results: At the end of 12 months, 46{\%} on the short course required additional steroids compared with 31{\%} on the low dose and 24{\%} on the high dose regimen.Conclusions: The two 20-week regimens were significantly better than the 12-week regimen. The high dose 20-week regimen was marginally and non-significantly better than the low dose regimen, but the high dose regimen contained 50{\%} more steroid. Reactions in leprosy persist over many months and require long courses of steroids.",
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T1 - Multi-centre, double blind, randomised trial of three steroid regimens in the treatment of type-1 reactions in leprosy

AU - Sundar Rao, P. S. S.

AU - Sugamaran, D. S. T.

AU - Richard, J.

AU - Smith, William Cairns Stewart

PY - 2006

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N2 - Objective: The objective of this randomized trial was to compare three different steroid regimens in treating type I reactions in leprosy in routine clinical practice.Design: The study design was a multicentre, double-blind, randomized, controlled, parallel group trial in patients with acute reversal reactions. The trial was conducted in six leprosy treatment centres in India. A total of 334 participants with acute type I reaction were recruited to the trial and randomized to one of three prednisolone regimens: high dose (60 mg per day) or low dose (30 mg per day) both tapered over 20 weeks, and short duration (60 mg per day tapered over 12 weeks). The main outcome measure was the proportion of patients failing to respond to treatment and requiring additional steroids.Results: At the end of 12 months, 46% on the short course required additional steroids compared with 31% on the low dose and 24% on the high dose regimen.Conclusions: The two 20-week regimens were significantly better than the 12-week regimen. The high dose 20-week regimen was marginally and non-significantly better than the low dose regimen, but the high dose regimen contained 50% more steroid. Reactions in leprosy persist over many months and require long courses of steroids.

AB - Objective: The objective of this randomized trial was to compare three different steroid regimens in treating type I reactions in leprosy in routine clinical practice.Design: The study design was a multicentre, double-blind, randomized, controlled, parallel group trial in patients with acute reversal reactions. The trial was conducted in six leprosy treatment centres in India. A total of 334 participants with acute type I reaction were recruited to the trial and randomized to one of three prednisolone regimens: high dose (60 mg per day) or low dose (30 mg per day) both tapered over 20 weeks, and short duration (60 mg per day tapered over 12 weeks). The main outcome measure was the proportion of patients failing to respond to treatment and requiring additional steroids.Results: At the end of 12 months, 46% on the short course required additional steroids compared with 31% on the low dose and 24% on the high dose regimen.Conclusions: The two 20-week regimens were significantly better than the 12-week regimen. The high dose 20-week regimen was marginally and non-significantly better than the low dose regimen, but the high dose regimen contained 50% more steroid. Reactions in leprosy persist over many months and require long courses of steroids.

KW - NERVE-FUNCTION IMPAIRMENT

KW - DAMAGE

KW - CORTICOSTEROIDS

KW - PROPHYLAXIS

KW - PREVENTION

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EP - 33

JO - Leprosy Review

JF - Leprosy Review

SN - 0305-7518

ER -