Leprosy treatment during pregnancy and breastfeeding: A case report and brief review of literature

Öztürk, Zeynep; Tatlıparmak, Aslı

doi:10.1111/dth.12414

Cited by 26 publications

(17 citation statements)

References 5 publications

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“…Even there is proven evidence, oral antihistamines can be used for itch management. In case of failure/contraindication/side effects of systemic corticosteroids, we suggest to consider during pregnancy intravenous immunoglobulin therapy and, as second step, conventional immunosuppressants/immunomodulating agents such as dapsone or azathioprine, which are the last choice, which can be used safely during pregnancy as inferred from many studies involving patients with other diseases treated with these agents (20)(21)(22)(23). In the postpartum/post-abortion period, we suggest as first step treatment immunosuppressant/immunomodulating agents, including dapsone and azathioprine, leaving as second choices IVIg and rituximab due to pharmacoeconomic reasons.…”

Section: Evidence About Pemphigoid Gestationis Treatment Emerged Frommentioning

confidence: 99%

A Systematic Review of Treatment Options and Clinical Outcomes in Pemphigoid Gestationis

et al. 2020

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Background: Treatment regimens for pemphigoid gestationis (PG) are non-standardized, with most evidence derived from individual case reports or small series.Objectives: To systematically review current literature on treatments and clinical outcomes of PG and to establish recommendations on its therapeutic management.Methods: An a priori protocol was designed based on PRISMA guidelines. PubMed, Scopus, and Web of Science databases were searched for English-language articles detailing PG treatments and clinical outcomes, published between 1970 and March 2020.Results: In total, 109 articles including 140 PG patients were analyzed. No randomized controlled trials or robust observational studies detailing PG treatment were found. Systemic corticosteroids ± topical corticosteroids and/or antihistamines were the most frequently prescribed treatment modality (n = 74/137; 54%). Complete remission was achieved by 114/136 (83.8%) patients. Sixty-four patients (45.7%) were given more than one treatment modality due to side effects or ineffectiveness. Leaving aside topical corticosteroids as monotherapy ± antihistamines in patients with mild disease, systemic corticosteroids ± topical corticosteroids and/or antihistamines led to complete remission in the highest proportion of patients (83%), while steroid-sparing treatments ± topical corticosteroids and/or antihistamines were associated with the lowest proportion of flares (55.5%).Limitations: The review has been drafted based on a limited number of single case reports and small case series. Underreporting/underdiagnosis of patients with mild-to-moderate PG, partial/absent follow-up, absence of precise description of neonatal outcomes and lack of validated objective scores for measuring disease severity are other limitations of our study. Our systematic review was affected by publication bias.Conclusion: Systemic corticosteroids are the most frequently used treatment for PG. Whilst most patients achieve complete remission, many of them have refractory/persistent disease requiring multiple lines of therapy. Therefore, we provided an algorithm for PG treatment integrating the results of this systematic review with current knowledge available for bullous pemphigoid. High-quality studies will further help assess the effectiveness of different treatment options for PG.

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Section: Evidence About Pemphigoid Gestationis Treatment Emerged Frommentioning

confidence: 99%

A Systematic Review of Treatment Options and Clinical Outcomes in Pemphigoid Gestationis

et al. 2020

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“…Ozturk and Tatliparmak describe a patient with multibacillary lepromatous leprosy who was treated with MDT during pregnancy and breastfeeding. 4 Anti-leprosy drugs are excreted into human milk but there is no report of adverse effects except for skin discoloration of the infant due to clofazimine. Multidrug therapy for leprosy patients should be continued unchanged during pregnancy and breastfeeding.…”

Section: Discussionmentioning

confidence: 99%

Leprosy with Erythema Nodosum Leprosum in Pregnancy: A Rare Phenomenon!

Vijay¹,

Sarma²

2019

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…All infants born were considered normal. Moreover, no significant adverse reactions due to clofazimine as part of the leprosy treatment regimen during pregnancy have been reported [ 88 , 107 , 108 , 121 , 122 ]. Clofazimine is furthermore safe to co-administer with antiretroviral therapy [ 123 ] and no known significant drug-drug interactions have been reported [ 88 , 121 ].…”

Section: Clofazimine An Orphan Drugmentioning

confidence: 99%

Adapting Clofazimine for Treatment of Cutaneous Tuberculosis by Using Self-Double-Emulsifying Drug Delivery Systems

2022

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Although chemotherapeutic treatment regimens are currently available, and considerable effort has been lavished on the development of new drugs for the treatment of tuberculosis (TB), the disease remains deeply intractable and widespread. This is due not only to the nature of the life cycle and extraordinarily disseminated habitat of the causative pathogen, principally Mycobacterium tuberculosis (Mtb), in humans and the multi-drug resistance of Mtb to current drugs, but especially also to the difficulty of enabling universal treatment of individuals, immunocompromised or otherwise, in widely differing socio-economic environments. For the purpose of globally eliminating TB by 2035, the World Health Organization (WHO) introduced the “End-TB” initiative by employing interventions focusing on high impact, integrated and patient-centered approaches, such as individualized therapy. However, the extraordinary shortfall in stipulated aims, for example in actual treatment and in TB preventative treatments during the period 2018–2022, latterly and greatly exacerbated by the COVID-19 pandemic, means that even greater pressure is now placed on enhancing our scientific understanding of the disease, repurposing or repositioning old drugs and developing new drugs as well as evolving innovative treatment methods. In the specific context of multidrug resistant Mtb, it is furthermore noted that the incidence of extra-pulmonary TB (EPTB) has significantly increased. This review focusses on the potential of utilizing self-double-emulsifying drug delivery systems (SDEDDSs) as topical drug delivery systems for the dermal route of administration to aid in treatment of cutaneous TB (CTB) and other mycobacterial infections as a prelude to evaluating related systems for more effective treatment of CTB and other mycobacterial infections at large. As a starting point, we consider here the possibility of adapting the highly lipophilic riminophenazine clofazimine, with its potential for treatment of multi-drug resistant TB, for this purpose. Additionally, recently reported synergism achieved by adding clofazimine to first-line TB regimens signifies the need to consider clofazimine. Thus, the biological effects and pharmacology of clofazimine are reviewed. The potential of plant-based oils acting as emulsifiers, skin penetration enhancers as well as these materials behaving as anti-microbial components for transporting the incorporated drug are also discussed.

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Leprosy treatment during pregnancy and breastfeeding: A case report and brief review of literature

Cited by 26 publications

References 5 publications

A Systematic Review of Treatment Options and Clinical Outcomes in Pemphigoid Gestationis

A Systematic Review of Treatment Options and Clinical Outcomes in Pemphigoid Gestationis

Leprosy with Erythema Nodosum Leprosum in Pregnancy: A Rare Phenomenon!

Adapting Clofazimine for Treatment of Cutaneous Tuberculosis by Using Self-Double-Emulsifying Drug Delivery Systems

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