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Year : 2022  |  Volume : 54  |  Issue : 3  |  Page : 177-182

Thalidomide and steroid in the management of erythema nodosum leprosum

1 Department of Pharmacology, SCB Medical College and Hospital, Cuttack, Odisha, India
2 Department of Skin and VD, SCB Medical College and Hospital, Cuttack, Odisha, India

Correspondence Address:
Dr. Rajashree Samal
Associate Professor, Department of Pharmacology, Sriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijp.ijp_946_21

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OBJECTIVE: The objective of the study was to assess the efficacy and safety profiles of combined treatment of prednisolone with thalidomide (Gr-A) and prednisolone with clofazimine (Gr. B) in patients with erythema nodosum leprosum (ENL) or type 2 lepra reactions. MATERIALS AND METHODS: Efficacy of both regimens was assessed on the basis of clinical recovery of recurrent ENL measured by reaction severity score (RSS), Visual Analog Scale (VAS), and recurrence of type 2 lepra reaction. The causality assessment of adverse drug reactions was done using the WHO UMC causality assessment scale. RESULTS: The average age of patients with recurrent ENL was 42.8 years (male) and 51.8yrs (female) and had mean duration of leprosy and recurrent ENL 2.4 years and 2.09 years, respectively. 80% of nonrecurrence was observed in Gr-A versus 66% in Gr-B. Significant (P < 0.05) lower RSS and VAS was found in both the treatment groups as compared to pretreatment value. The reduction in RSS and VAS was statistically significant (P < 0.05) in Gr-A compared to Gr-B treatment. CONCLUSION: Thalidomide combination with steroid was found to be more efficacious than clofazimine combination with steroid in the treatment of ENL both the treatment regimens showed few tolerable side effects. Improved strategies for the treatment and management of these reactions need to be developed.


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