Effect of dapsone on haemoglobin concentration in patients with leprosy

Byrd, Sally R.; Gelber, Robert H.

doi:10.5935/0305-7518.19910020

Cited by 19 publications

(11 citation statements)

References 4 publications

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“…On average, 80% of patients taking a daily dose of 100 - 150 mg dapsone will have a drop of at least 1 g/dL in hemoglobin concentration (32, 33). Another common side effect of dapsone is methemoglobinemia, a condition caused by physiologic ferrous (Fe 2+ ) heme iron oxidized to its ferric state (Fe 3+ ) (17).…”

Section: Discussionmentioning

confidence: 99%

Double-Blind Placebo-Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

Morgan

Cooke

Rogers

et al. 2014

The Journal of Allergy and Clinical Immunology: In Practice

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Background Management of antihistamine refractory CIU has poorly defined therapeutic options. Objective To evaluate the efficacy of dapsone in antihistamine refractory CIU compared to placebo. Methods Twenty-two patients with antihistamine refractory CIU were randomly assigned to 100 mg of dapsone daily or placebo for 6 weeks in a 14 week double-blind, placebo-controlled crossover trial. Endpoints were measured from a daily diary reflecting weekly hive score (WHS) and weekly itch score (WIS) and a visual analog score. Secondary to a carryover effect, the first period results were analyzed as a parallel design comparing placebo to dapsone directly using repeated measures analysis. Results After 6 weeks patients in the dapsone arm showed mean improvement over baseline in VAS (+2.3 [0.6,4.1], p=0.01), urticaria score (-3.5 [-6.2, -0.9], p=0.01), and itch score (-4.8 [-7.6, -2.1], p=0.001), whereas the placebo arm showed no improvement over baseline for VAS, urticaria or itch scores. Dapsone showed greater improvement compared to placebo for itch (p=0.047) and VAS (p=0.04). Of the 22 patients, 3 showed complete resolution of hives and itch with dapsone, while 31% and 41% had ≥ 50% resolution of hives and itch respectively. No serious adverse effects were observed from dapsone. Conclusion To our knowledge, this is the first DBPC study of dapsone in CIU and suggests dapsone has efficacy in antihistamine refractory CIU patients.

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Section: Discussionmentioning

confidence: 99%

Double-Blind Placebo-Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

Morgan

Cooke

Rogers

et al. 2014

The Journal of Allergy and Clinical Immunology: In Practice

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“…Third, glucose 6-phosphate dehydrogenase (G6PD) levels are critical for metabolism of the drug. [62] Patients with G6PD deficiency are more susceptible to developing hemolysis. It is critical to highlight that, compared with corticosteroids, the adverse-effect profile of dapsone is far less serious and in most instances the adverse effects are reversible.…”

Section: Adverse Effectsmentioning

confidence: 99%

Efficacy of Dapsone in the Treatment of Pemphigus and Pemphigoid

Gürcan

Ahmed

2009

American Journal of Clinical Dermatology

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Dapsone is a chemotherapeutic agent primarily used in treating leprosy, Pneumocystis jiroveci (previously carinii) pneumonia, and malaria. It is also used as an adjuvant in the treatment of pemphigus and pemphigoid. To assess the role of dapsone in the treatment of pemphigus and pemphigoid, a retrospective review of reports in the English-language literature was conducted. Information on the number of patients treated, their average age, prior therapies, indications for use, protocol (dose and interval) used, concomitant therapies, reported adverse effects, and clinical outcomes were analyzed. There were 35 case reports/series published describing the use of dapsone in a total of 427 patients. Data on 55 pemphigus patients were obtained from several case reports and some case series and one randomized controlled trial. Of these, 32 patients with pemphigus vulgaris and 14 patients with pemphigus foliaceus responded to dapsone. Data from 13 case series, each including at least five patients, accounted for 372 patients with pemphigoid. The overall response rates to dapsone, when given either alone or in combination with corticosteroids or immunosuppressive agents, were 84% in mucous membrane pemphigoid, and 81% in bullous pemphigoid. Hemolysis was the most common adverse effect observed. Dapsone is a promising and useful agent in patients with autoimmune mucocutaneous blistering diseases, especially in mucous membrane pemphigoid. It can be used as a corticosteroid-sparing agent. Therefore, its combined use with oral corticosteroids may be useful in pemphigus vulgaris and bullous pemphigoid. Adverse effects of dapsone are dose dependent and usually reversible. Hemolysis and concomitant anemia secondary to hemolysis are expected in most patients. In the opinion of the authors, dapsone is underutilized in the treatment of autoimmune mucocutaneous blistering diseases.

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“…DDS‐NHOH can also induce erythrocyte removal in rat (Grossman et al ., 1995; McMillan et al ., 1995) and morphological alteration in human erythrocytes (McMillan et al ., 1995). The drug has long been associated with shortening of the erythrocytic lifespan in man (Cream, 1970; Byrd and Gelber, 1991) and this remains a clinical problem (Wertheim et al ., 2006). Indeed, anaemia is already a major cause of mortality and morbidity in areas where dapsone is used to treat malaria (Gonazales et al ., 2000).…”

Section: Introductionmentioning

confidence: 99%

Dapsone hydroxylamine induces premature removal of human erythrocytes by membrane reorganization and antibody binding

Bordin

Fiore

Zen

et al. 2010

British J Pharmacology

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BACKGROUND AND PURPOSE N-hydroxylation of dapsone leads to the formation of the toxic hydroxylamines responsible for the clinical methaemoglobinaemia associated with dapsone therapy. Dapsone has been associated with decreased lifespan of erythrocytes, with consequences such as anaemia and morbidity in patients treated with dapsone for malaria. Here, we investigated how dapsone and/or its hydroxylamine derivative (DDS-NHOH) induced erythrocyte membrane alterations that could lead to premature cell removal. EXPERIMENTAL APPROACH Erythrocytes from healthy donors were subjected to incubation with dapsone and DDS-NHOH for varying times and the band 3 protein tyrosine-phosphorylation process, band 3 aggregation, membrane alteration and IgG binding were all examined and compared with erythrocytes from two patients receiving dapsone therapy. KEY RESULTS The hydroxylamine derivative, but not dapsone (the parent sulphone) altered membrane protein interactions, leading both to aggregation of band 3 protein and to circulating autologous antibody binding, shown in erythrocytes from patients receiving dapsone therapy. The band 3 tyrosine-phosphorylation process can be used as a diagnostic system to monitor membrane alterations both in vitro, assessing concentration and time-dependent effects of DDS-NHOH treatment, and in vivo, evaluating erythrocytes from dapsone-treated patients, in resting or oxidatively stimulated conditions. CONCLUSIONS AND IMPLICATIONS DDS-NHOH-induced alterations of human erythrocytes can be directly monitored in vitro by tyrosine-phosphorylation level and formation of band 3 protein aggregates. The latter, together with antibody-mediated labelling of erythrocytes, also observed after clinical use of dapsone, may lead to shortening of erythrocyte lifespan

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Effect of dapsone on haemoglobin concentration in patients with leprosy

Cited by 19 publications

References 4 publications

Double-Blind Placebo-Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

Double-Blind Placebo-Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

Efficacy of Dapsone in the Treatment of Pemphigus and Pemphigoid

Dapsone hydroxylamine induces premature removal of human erythrocytes by membrane reorganization and antibody binding

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