Evaluating the Rate and Timing of Reactions Among Patients With Hansen's Disease. Issue 3 (May 2022)

• Record Type: Journal Article
• Authors: Pino-y-Torres, Bobbi L.; Flynn, Amy L.; Dudley, Mary P.; Lea, Jacqueline W.; Luu, Lori M.; Thornlow, Deirdre K.
• Is Part Of: Journal of the Dermatology Nurses' Association. Volume 14:Issue 3(2022)
• Page Start: 113
• Page End: 121
• Publication Date: 2022-05
• Subjects: Clofazimine -- Erythema Nodosum Leprosum -- Hansen's Disease -- Leprosy -- Minocycline -- Multidrug Therapy -- National Hansen's Disease Program -- Reversal Reaction; Dermatologic nursing -- Periodicals; Skin Diseases -- nursing -- Periodicals; Dermatology -- Periodicals; Dermatologic nursing; Periodicals; 616.505
• DOI: 10.1097/JDN.0000000000000683
• Languages: English
• ISSNs: 1945-760X

Abstract

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 (χ 2 [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.