A retrospective study of the effect of modified multi-drug therapy in Nepali leprosy patients following the development of adverse effects due to dapsone

INTRODUCTION: Dapsone Hypersensitivity Syndrome (DHS) occurs in approximately 2% of leprosy patients in Nepal. DHS and other adverse effects of dapsone lead to withdrawal of the drug. METHODS: We reviewed the notes of patients who had dapsone withdrawn from their multi-drug therapy (MDT) following an adverse reaction to the drug between 1990 and 2007. RESULTS: 105 patients were identified from the database and 67 had a documented completion of a modified course of MDT. The majority were treated with rifampicin and clofazimine. All 36 individuals who were slit-skin smear positive had a satisfactory fall in their mean bacterial index. There were no cases of relapse. CONCLUSIONS: Rifampicin and clofazimine appear to be satisfactory treatment for both paucibacillary and multibacillary patients who have to have dapsone stopped because of severe adverse effects.