Evaluating the Rate and Timing of Reactions Among Patients With Hansen’s Disease

Bobbi L. Pino-y-Torres, Amy L. Flynn, M. Dudley, J. Lea, Lori M. Luu, D. Thornlow
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Abstract

Background Immunologic reactions are a major complication of Hansen’s disease, also known as leprosy. To minimize reactions, clofazimine is added to multidrug therapy for its anti-inflammatory effect. Minocycline is an alternative antileprosy medication that has evidence to suggest it also has anti-inflammatory properties. Objective The aim of this study was to evaluate whether there is a difference in the frequency of reactional episodes and time of onset while receiving minocycline for Hansen's disease compared with multidrug therapy. Methods This study used an observational design comparing two independent groups. Results No differences were found between reaction occurrence and time to onset in patients who received either alternative therapy with minocycline or standard multidrug therapy treatment with clofazimine. Logistic regression indicated a significant association between borderline tuberculoid and reactions (χ2[1] = 3.898, p = .048). Patients with borderline tuberculoid were 68% less likely to develop reactions (Type 1 or 2) than other types of Hansen's disease while accounting for treatment, age, and race (OR = 0.320, 95% CI [0.103, 0.992]). Conclusion Although there was no significant difference in reaction rate between treatment groups, these findings indicate the clinical form borderline tuberculoid is a significant negative predictor for reactions. However, sample size limited the ability to determine significance based on reaction type.
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评估麻风病患者的反应率和时间
背景免疫反应是汉森病(又称麻风病)的主要并发症。为了减少反应,氯法齐明被加入到多药治疗中,因为它具有抗炎作用。米诺环素是另一种抗麻风病药物,有证据表明它也具有抗炎特性。目的本研究的目的是评估在接受米诺环素治疗汉森氏病时,与多药治疗相比,是否存在反应性发作的频率和发病时间的差异。方法本研究采用观察设计,比较两个独立的组。结果接受米诺环素替代治疗和氯法齐明标准多药治疗的患者的反应发生率和发病时间均无差异。Logistic回归分析结果显示,交界型结核菌与反应有显著相关性(χ2[1] = 3.898, p = 0.048)。考虑到治疗、年龄和种族等因素,交界性结核样蛋白患者发生1型或2型反应的可能性比其他类型汉森氏病低68% (or = 0.320, 95% CI[0.103, 0.992])。结论虽然两组间的反应率无显著性差异,但这些结果表明,临床形式交界性结核样蛋白是反应的显著阴性预测因子。然而,样本量限制了根据反应类型确定显著性的能力。
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来源期刊
CiteScore
0.30
自引率
25.00%
发文量
45
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