02586nas a2200361   4500000000100000008004100001260001200042653002500054653002500079653001300104653001200117653002600129653001100155100001100166700001100177700000900188700000900197700001100206700001000217700001000227700001100237700001100248700000900259700001000268700000900278700001100287700001000298700001000308700001000318245011300328520176900441022001402210       2023                            d  c02/202310aMycobacterium leprae10aAntibiotic treatment10aEfficacy10aleprosy10anetwork meta-analysis10aSafety1 aYang J1 aKong J1 aLi B1 aJi Z1 aChen J1 aLiu M1 aFan Y1 aPeng L1 aSong J1 aWu X1 aGao L1 aMa W1 aDong Y1 aLuo S1 aLiu A1 aBao F00aSeventy years of evidence on the efficacy and safety of drugs for treating leprosy: a network meta-analysis.3 a<p><strong>OBJECTIVE: </strong>The World Health Organization (WHO) recommends multidrug therapy (MDT) with rifampicin, dapsone, and clofazimine for treating leprosy, which based on very low-quality evidence. Here we performed a network meta-analysis (NMA) to produce quantitative evidence to strengthen current WHO recommendations.</p>

<p><strong>METHOD: </strong>All studies were obtained from Embase and PubMed from the date of establishment to October 9, 2021. Data were synthesized with frequentist random-effects network meta-analyses. Outcomes were assessed using odds ratios (ORs), 95% confident intervals (95% CIs) and P score.</p>

<p><strong>RESULTS: </strong>Sixty controlled clinical trials and 9256 patients were included. MDT was effective (range of OR: 1·06-1255584·25) for treating leprosy and multibacillary leprosy. Six treatments (Range of OR: 1.199-4.50) were more effective than MDT. Clofazimine (P score=0.9141) and dapsone+rifampicin (P score=0·8785) were effective for treating type 2 leprosy reaction. There were no significant differences in the safety of any of the tested drug regimens.</p>

<p><strong>CONCLUSIONS: </strong>The WHO MDT is effective for treating leprosy and multibacillary leprosy, but it may not be effective enough. Pefloxacin and ofloxacin may be good adjunct drugs for increasing MDT efficacy. Clofazimine and dapsone+rifampicin can be used in the treatment of a type 2 leprosy reaction. Single drug regimens are not efficient enough to treat leprosy, multibacillary leprosy, or a type 2 leprosy reaction.</p>

<p><strong>AVAILABILITY OF DATA AND MATERIALS: </strong>All data generated or analysed during this study are included in this published article [and its supplementary information files].</p>
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