Journal article
Novel approaches in the treatment of Hansen’s disease (Leprosy): a case series of multidrug therapy of monthly rifampin, moxifloxacin, and minocycline (RMM) in the United States
Therapeutic advances in infectious disease, Vol.9, p.204993612211358
11/08/2022
DOI: 10.1177/20499361221135885
PMCID: PMC9647311
PMID: 36387060
Abstract
The World Health Organization (WHO) recommends multidrug therapy (MDT) for the
treatment of paucibacillary and multibacillary forms of leprosy, also known as
Hansen’s disease (HD). MDT combinations of dapsone, rifampin, and clofazimine
have reduced the prevalence of the disease but are not without adverse effects
impacting regimen adherence. Hence, an urgent need exists to consider
alternative MDT regimens with an improved safety profile that promotes treatment
adherence. Herein, we described a case series of 10 patients with HD (nine
patients with multibacillary leprosy and one with pure neural leprosy) treated
with monthly rifampin, moxifloxacin, and minocycline (RMM). The United States
National Hansen’s Disease Program (NHDP) diagnosed and treated patients across
US institutions. All patients received a regimen of 12–24 months of RMM. We
reviewed the clinical outcomes, adherence, rate of completion, and adverse
events of patients treated with monthly RMM from January 2019 to August 2022.
Nine patients had multibacillary leprosy, with some having type-2 reactions. One
patient had pure neural leprosy with a reversal reaction. In this case series,
we identified that all patients completed the RMM regimen without treatment
interruptions. None of the patients experienced any skin hyperpigmentation or
any significant side effects. All patients tolerated the monthly RMM regimen
with rapid improvement of skin lesions and without logistic hurdles. Based on
previous clinical evidence and the results of this case series, the NHDP and
other programs should consider the RMM regimen as first-line therapy.
Details
- Title: Subtitle
- Novel approaches in the treatment of Hansen’s disease (Leprosy): a case series of multidrug therapy of monthly rifampin, moxifloxacin, and minocycline (RMM) in the United States
- Creators
- Carlos Franco-Paredes - Hospital Infantil de México Federico GómezElizabeth Garcia-Creighton - University of Colorado DenverAndrés Henao-Martínez - University of Colorado Anschutz Medical CampusDiane L. Kallgren - Kallgren Dermatology, Boulder, CO, USA.Rashmi Banjade - Penn State Milton S. Hershey Medical CenterJon A. Dyer - University of MissouriTaylor Nelson - University of MissouriAraya Zaesim - University of MissouriMichael J. Peluso - San Francisco General HospitalVivek Jain - San Francisco General HospitalDong Heun Lee - University of California, San FranciscoLucio R. Minces - Infectious Disease, Carris Health (CentraCare), Willmar, MN, USA.Mary Wirshup - Community Service VolunteersMiguel Sierra Hoffman - Infectious Disease Department and Pulmonary Department, Texas A&M Victoria Campus, and Family Medicine Residency Program, Victoria, TX, USAJenn Katsolis - St. Vincent's HealthCareKaren Brust - Roy J. and Lucille A. Carver College of MedicineJose Giron - Sunshine Specialty Health Care and Florida State University, College of Medicine, Tallahassee, FL, USA.Lauren Smiarowski - Sunshine Specialty Health Care and Florida State University, College of Medicine, Tallahassee, FL, USA.Pauline A. Hoosepian-Mer - Cedars-Sinai Medical CenterBarbara Stryjewska - National Hansen's Disease Program
- Resource Type
- Journal article
- Publication Details
- Therapeutic advances in infectious disease, Vol.9, p.204993612211358
- DOI
- 10.1177/20499361221135885
- PMID
- 36387060
- PMCID
- PMC9647311
- NLM abbreviation
- Ther Adv Infect Dis
- ISSN
- 2049-9361
- eISSN
- 2049-937X
- Publisher
- SAGE Publications
- Language
- English
- Date published
- 11/08/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984359859902771
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