Leprosy
Mailing List – February 10th, 2010
Ref.: Lamprene
(clofazimine)
From: Pieter
AM Schreuder, Maastricht, The Netherlands
Dear
Salvatore,
Just visited the Cebu Skin Clinic, which is part of the Leonard Wood
Memorial
Foundation
,
Philippines
. Excellent physicians -
careful treatment of reactions, prevention of disabilities and a
surveillance system which follows up patients for years after released
from treatment (RFT). They
told me that they see nowadays many more multibacillary patients with
erythema nodosum leprosum (ENL) reaction after RFT, compared to
the two years regimen of the past. Wim
van Brakel is right saying that such statements should be based on
proper research. As far
as I understood a new research protocol has been finalised.
Again, the question is why an excellent drug like Lamprene is so
easily disregarded? Are the good experiences with Lamprene in case of
ENL in Southeast and
East Asia
so different from other parts of the world? Yes,
indeed, it has its side-effects but in general much less than
the other drugs in common use.
Lamprene is in most programs the only alternative to steroids in case
of ENL. Especially in steroids-dependent ENL the corticosteroids can
only be tapered off successfully (in the absence of Thalidomide) under
coverage of high doses Lamprene.
We again have to stress that is imperative that loose Lamprene drugs
should be made available to national programs in sufficient
quantities. One problem
seems to be that Lamprene is not available at the free market anymore?
Best regards,
Pieter
AM Schreuder
