@article{99909, keywords = {Clinical trial, leprosy, Relapse, Uniform multidrug therapy}, author = {Penna G and Pontes M and Talhari S and Gonçalves H and Cortez C and Pessoa A and Pedroza V and Bührer-Sékula S and Stefani M and Penna M}, title = {Late relapses in leprosy patients in Brazil: 10-year post-trial of uniform multidrug therapy (U-MDT/CT-BR).}, abstract = {

Background: Leprosy is a neglected dermato-neurologic, infectious disease caused by Mycobacterium leprae or M. lepromatosis. Leprosy is treatable and curable by multidrug therapy/MDT, consisting of 12 months rifampicin, dapsone and clofazimine for multibacillary/MB patients and for 6 months for paucibacillary/PB patients. The relapse rate is considered a crucial treatment outcome. A randomized Controlled Trial (U-MDT/CT-BR) conducted from 2007‒2012 compared clinical outcomes in MB patients after 12 months regular MDT/R-MDT and 6 months uniform MDT/U-MDT in two highly endemic Brazilian areas.

Objectives: To estimate the 10 years relapse rate of MB patients treated with 6 months U-MDT.

Methods: The statistical analyses treated the data as a case-control study, sampled from the cohort generated for the randomized trial. Analyses estimated univariate odds ratio and applied logistic regression for multivariate analysis, controlling the confounding variables.

Results: The overall relapse rate was 4.08 %: 4.95 % (16 out of 323) in the U-MDT group and 3.10 % (9 out of 290) in the regular/R-MDT group. The difference in relapse proportion between U-MDT and R-MDT groups was 1.85 %, not statistically significant (Odds Ratio = 1.63, 95 % CI 0.71 to 3.74). However, misdiagnosis of relapses, may have introduced bias, underestimating the force of the association represented by the odds ratio.

Conclusions: The relapse estimate of 10 years follow-up study of the first randomized, controlled study on U-MDT/CT-BR was similar to the R-MDT group supporting strong evidence that 6 months U-MDT for MB patients is an acceptable option to be adopted by leprosy endemic countries worldwide.

Trial Registration: ClinicalTrials.gov: NCT00669643.

}, year = {2024}, journal = {The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases}, pages = {1-8}, month = {04/2024}, issn = {1678-4391}, url = {https://www.sciencedirect.com/science/article/pii/S141386702400028X/pdfft?md5=7d145991c7d7997f91f2ae5c746b7fcf&pid=1-s2.0-S141386702400028X-main.pdf}, doi = {10.1016/j.bjid.2024.103745}, language = {eng}, }