lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

World Health Organization (WHO) Antibiotic Regimen Against Other Regimens for the Treatment of Leprosy: A Systematic Review and Meta-Analysis

35 Pages Posted: 14 Feb 2019

See all articles by Maria Lazo-Porras

Maria Lazo-Porras

University of Geneva

Gabriela J. Prutski

Universidad Peruana Cayetano Heredia - CRONICAS Center of Excellence in Chronic Diseases

Patricia Barrionuevo

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Jose C. Tapia

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Cesar Ugarte-Gil

Universidad Peruana Cayetano Heredia - Facultad de Medicina Alberto Hurtado

Oscar J. Ponce

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Ana Acuña-Villaorduña

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Juan P. Domecq

Mayo Clinic

Celso De La Cruz-Luque

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Larrry J. Prokop

Mayo Clinic

German Malaga

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia; Universidad Peruana Cayetano Heredia - CRONICAS Center of Excellence in Chronic Diseases; Universidad Peruana Cayetano Heredia - Facultad de Medicina Alberto Hurtado

More...

Abstract

Objective: To evaluate the effectiveness and safety of the WHO antibiotic regimen for the treatment of paucibacillary (PB) and multibacillary (MB) leprosy compared to other available regimens.

Methods: We performed a search from 1982 to July 2018 without language restriction. We included randomized controlled trials, quasi-randomized trials, and comparative observational studies (cohorts and case-control studies) that enrolled patients of any age with PB or MB leprosy that were treated with any of the leprosy antibiotic regimens established by the WHO in 1982 and used any other antimicrobial regimen as a controller. Primary efficacy outcomes included: complete clinical cure, clinical improvement of the lesions, relapse rate, treatment failure. Data were pooled using a random effects model to estimate the treatment effects reported as relative risk (RR) with 95% confidence intervals (CI).

Results: We found 24 eligible studies, 11 evaluated patients with paucibacillary leprosy, while 13 evaluated patients with MB leprosy. Diverse regimen treatments and outcomes were studied. Complete cure at 6 months of Multidrug Therapy (MDT) in comparison to Rifampin-Ofloxacin-Minocycline (ROM) found RR of 1.02 (95% CI 0.92 - 1.15) in four studies. Whereas six studies compare the same outcome at different follow up periods between 6 months and 5 years, according to the analysis a significant difference was found with a RR of 1.10 (95% CI 1.01 - 1.20).

Conclusion: Not better treatment than the implemented by the World Health Organization was found. Diverse outcome and treatment regimens were studied, more statements to standardized the measurements of outcomes are needed.

Funding Statement: We have not received any fund to carry it out and it has been subsidized by the researchers.

Declaration of Interests: "None"

Ethics Approval Statement: This review was reported following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Keywords: leprosy, treatment, systematic review, world health organization

Suggested Citation

Lazo-Porras, Maria and Prutski, Gabriela J. and Barrionuevo, Patricia and Tapia, Jose C. and Ugarte-Gil, Cesar and Ponce, Oscar J. and Acuña-Villaorduña, Ana and Domecq, Juan P. and Cruz-Luque, Celso De La and Prokop, Larrry J. and Malaga, German, World Health Organization (WHO) Antibiotic Regimen Against Other Regimens for the Treatment of Leprosy: A Systematic Review and Meta-Analysis (October 29, 2018). Available at SSRN: https://ssrn.com/abstract=3276429 or http://dx.doi.org/10.2139/ssrn.3276429

Maria Lazo-Porras

University of Geneva

102 Bd Carl-Vogt
Genève, CH - 1205
Switzerland

Gabriela J. Prutski

Universidad Peruana Cayetano Heredia - CRONICAS Center of Excellence in Chronic Diseases

Lima
Peru

Patricia Barrionuevo

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Lima
Peru

Jose C. Tapia

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Lima
Peru

Cesar Ugarte-Gil

Universidad Peruana Cayetano Heredia - Facultad de Medicina Alberto Hurtado

Lima
Peru

Oscar J. Ponce

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Lima
Peru

Ana Acuña-Villaorduña

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Lima
Peru

Juan P. Domecq

Mayo Clinic

200 First Street SW
Rochester, MN (507) 284-2511 55905
United States

Celso De La Cruz-Luque

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia

Lima
Peru

Larrry J. Prokop

Mayo Clinic

200 First Street SW
Rochester, MN (507) 284-2511 55905
United States

German Malaga (Contact Author)

Universidad Peruana Cayetano Heredia - CONEVID Unidad de Conocimiento y Evidencia ( email )

Lima
Peru

Universidad Peruana Cayetano Heredia - CRONICAS Center of Excellence in Chronic Diseases ( email )

Lima
Peru

Universidad Peruana Cayetano Heredia - Facultad de Medicina Alberto Hurtado ( email )

Lima
Peru