World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy : a systematic review and meta-analysis
Lazo-Porras, Maria (Geneva University Hospitals (Suïssa))
Prutsky, Gabriela J. (Mayo Clinic Health System. Department of Pediatrics)
Barrionuevo, Patricia (Universidad Peruana Cayetano Heredia. CONEVID Unidad de Conocimiento y Evidencia, School of Medicine "Alberto Hurtado")
Tapia, Jose Carlos (Institut d'Investigació Biomèdica Sant Pau)
Ugarte-Gil, Cesar (Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine)
Ponce, Oscar J. (Universidad Peruana Cayetano Heredia. CONEVID Unidad de Conocimiento y Evidencia, School of Medicine "Alberto Hurtado")
Acuña-Villaorduña, Ana (Montefiore Medical Center-Albert Einstein College of Medicine)
Domecq, Juan Pablo (Mayo Clinic. Division of Pulmonary and Critical Care Medicine)
De la Cruz-Luque, Celso (Jackson Memorial Hospital. Cardiology division)
Prokop, Larry J. (Mayo Clinic. Evidence-based Practice Center)
Málaga, Germán (Universidad Peruana Cayetano Heredia. School of Medicine "Alberto Hurtado")
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	To evaluate the effectiveness and safety of the World Health Organization antibiotic regimen for the treatment of paucibacillary (PB) and multibacillary (MB) leprosy compared to other available regimens. 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). We found 25 eligible studies, 11 evaluated patients with paucibacillary leprosy, while 13 evaluated patients with MB leprosy and 1 evaluated patients of both groups. 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. 06 (95% CI 0. 88-1. 27) in five studies. Whereas six studies compare the same outcome at different follow up periods between 6 months and 5 years, according to the analysis ROM was not better than MDT (RR of 1. 01 (95% CI 0. 78-1. 31)) in PB leprosy. Not better treatment than the implemented by the WHO was found. Diverse outcome and treatment regimens were studied, more statements to standardized the measurements of outcomes are needed.
Note:	Altres ajuts: Maria Lazo-Porras is funded by the Swiss Goverment Excellence Scholarship (2018.0698).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Leprosy ; Treatment ; Systematic review ; World Health Organization
Published in:	BMC Infectious diseases, Vol. 20 (january 2020) , ISSN 1471-2334

DOI: 10.1186/s12879-019-4665-0
PMID: 31959113

14 p, 1.6 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles