Leprosy
Mailing List, December 24th, 2008
Ref.:
Steroid
therapy in leprosy should be individualised.
From:
Chukwu
J.,
Enugu
,
Nigeria
Dear Noto,
I would like
to congratulate you and all LML readers/contributors on the current
vigorous debate on duration of steroid regimens for leprosy reactions.
Our hope and indeed
expectation is that this healthy exchange should not end in winners
and losers but rather in a broad consensus and joint action to
establish an evidence-based regimen.
It is
reassuring to learn that a protocol is already in place for a
multi-centre trial (Wim van Brakel LML Dec. 2, 2008). In view of
the great diversity in relation to man and microbe as acknowledged by
Dr. Ben Naafs (….’leprosy in one geographical area is not that in
another’) as well as the need to complete enrolment quickly, I
suggest that the trial co-ordinators consider including more
countries.
As we embark
on the study, it is important that some consensus is achieved on what
to do with the current guidelines: should we recommend that cases of
severe reaction be managed with individually-tailored steroid regimens
in referral centres until study results are available?
Best wishes
from
Nigeria
,
Joseph Chukwu
GLRA
Nigeria
