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DOI: 10.1055/s-2004-814281
Aktuelle Aspekte der Lepra-Therapie
Current Aspects of Leprosy TherapyPublication History
Publication Date:
03 March 2004 (online)
Zusammenfassung
Die medikamentöse Therapie der Lepra hat in den letzten Jahrzehnten erhebliche Fortschritte gemacht. Vor dem Hintergrund der weltweiten Bemühungen um die Elimination der Erkrankung werden historische, gegenwärtige sowie neue und experimentelle Therapiestrategien erörtert und kritisch gewürdigt. Bedingungen für den künftigen Einsatz therapeutischer Regime sowie wesentliche Herausforderungen im Hinblick auf die medikamentöse Therapie der Lepra werden aufgezeigt.
Abstract
Drug therapy of leprosy has made great advances in the past decades. Regarding the worldwide efforts towards the elimination of the disease, historical, current and new, as well as experimental therapeutic strategies, are discussed and critically assessed. Conditions for the future application of therapeutic regimens, and essential challenges concerning the drug therapy of leprosy are elaborated.
Literatur
- 1 World Health Assembly . Leprosy resolution 44.9. Forty-fourth World Health Assembly 13. 5. 1991
- 2 World Health Assembly .Press release World Health Assembly 54/2,. 16. 5. 2001
- 3 World Health Organization .The final push strategy to eliminate leprosy as a public health problem. Questions and answers. 2.Aufl. Genf; World Health Organization 2003
- 4 Lockwood D N. Leprosy elimination - a virtual phenomenon or a reality?. Brit Med J. 2002; 324 (7352) 1516-1518
- 5 Stearns A T. Leprosy: a problem solved by 2000. Lepr Rev. 2002; 73 (3) 215-224
- 6 Feenstra P. „Elimination” of leprosy and the need to sustain leprosy services, expectations, predictions and reality. Int J Lepr Other Mycobact Dis. 2003; 71 (3) 248-256
- 7 Yawalkar S J. Leprosy for Medical Practitioners and Paramedical Workers. 7. Auflage. Basel; Novartis Stiftung 2002
- 8 Faget G H, Pogge R C, Johansen F A, Dinan J F, Prejean B M, Eccles C G. The promin treatment of leprosy - a progress report. Pub Health Rep. 1943; 58 1729-1741
- 9 Fromm E, Wittmann J. Derivate des p-Nitrophenols. Berichte Deutsch Chem Ges. 1908; 41 2264-2273
- 10 Cochrane R, Ramanujam H, Paul H. et al . Two-and-a-half years experimental work on the sulphone group of drugs. Lepr Rev. 1949; 20 4-64
- 11 Lowe J. The late results of sulphone treatment of leprosy in East Nigeria. Lepr Rev. 1954; 25 (3) 13-124
- 12 Pettit J HS, Rees R JW. Sulphone resistance in leprosy. An experimental and clinical study. Lancet. 1964; II 673-674
- 13 Pearson J MH, Haile G S, Rees R JW. Primary dapsone-resistant leprosy. Lepr Rev. 1977; 48 (2) 129-132
- 14 WHO-Study Group .Chemotherapy of leprosy for control programmes. Tech Rep Ser 675. Genf; World Health Organization 1982
- 15 World Health Organization .Guide to Eliminate Leprosy as a Public Health Problem. WHO/CDS/CPE/CEE/2000.14. Genf; World Health Organization 2000
- 16 Georgiev G D, McDougall A C. Blister calendar packs - potential for the improvement in supply and utilization of multiple drug therapy in leprosy control programmes. Int J Lepr. 1988; 56 (4) 603-610
- 17 Huikeshoven H. Patient compliance in leprosy control: a necessity in old and new regimens. Int J Lepr. 1985; 53 (3) 474-480
- 18 Ridley D S, Jopling W H. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis. 1966; 34 (3) 255-273
- 19 WHO Expert Committee on Leprosy .6th Report. Tech Rep Ser 768. Genf; World Health Organization 1988
- 20 Goulart I M, Arbex G L, Carneiro M H, Rodrigues M S, Gadia R. [Adverse effects of multidrug therapy in leprosy patients: a five-year survey at a Health Center of the Federal University of Uberlandia]. Rec Soc Bras Med Trop. 2002; 35 (5) 453-460 (portugiesisch)
- 21 . Editorial. Adverse reactions to dapsone. Lancet. 1981; II 184-185
- 22 Rees R JW, Pearson J MH, Waters M FR. Experimental and clinical studies of rifampicin in treatment of leprosy. Brit Med J. 1970; 1 89-x
- 23 Leiker D L, Kamp H. First results of treatment of leprosy with Rifadin. Lepr Rev. 1970; 41 (1) 25-30
- 24 Languillon J, Yawalkar S J, McDougall A C. Therapeutic effect of adding rimactane (rifampicin) 450 milligrams daily or 1200 milligrams once monthly in a single dose to dapsone 50 milligrams daily in patients with lepromatous leprosy. Int J Lepr. 1979; 47 (1) 37-43
- 25 Browne S G, Hogerzeil L M. „B 663” in the treatment of leprosy. Preliminary report of a pilot trial. Lepr Rev. 1962; 33 6-10
- 26 Waters M FR. G 30 320 or B 663 - Lampren (Geigy). Lepr Rev. 1969; 40 (1) 21-47
- 27 Zimmerli-Ning M, Vischer W. A retrospective survey of the tolerability of clofazimine in patients with bacilliferous leprosy. Abstract III/137(A). New Delhi; XII. International Leprosy Congress 1984
- 28 Jacobson R R, Hastings R C. Rifampicin resistant leprosy. Lancet. 1976; II 1304-1305
- 29 Grosset J H, Guelpa-Lauras C C, Bobin P, Brucker G, Cartel J L, Constant-Desportes M, Flageul B, Frederic M, Guillaume J C, Millan J. Study of 39 documented relapses of multibacillary leprosy after treatment with rifampicin. Int J Lepr. 1989; 57 (3) 607-614
- 30 WHO Study Group .Chemotherapy of leprosy. Tech Rep Ser 874. Genf; World Health Organization 1998
- 31 Yoder L J, Jacobson R R, Hastings R C. The activity of rifabutin against Mycobacterium leprae. Lepr Rev. 1991; 62 (3) 280-287
- 32 Ji B, Grosset J. Combination of rifapentine-moxifloxacin-minocycline (PMM) for the treatment of leprosy. Lepr Rev. 2000; 71 (Suppl.) S81-S87
- 33 Grosset J H. Newer drugs in leprosy. Int J Lepr Other Mycobakt Dis. 2001; 69 (Suppl.) S14-S18
- 34 Gelber R H. Successful treatment of a lepromatous patient with clarithromycin. Int J Lepr Other Mycobact Dis. 1995; 63 (1) 113-115
- 35 Ji B, Jamet P, Perani E G, Sow S, Lienhardt C, Petinon C, Grosset J H. Bactericidal activity of single dose of clarithromycin plus minocycline, with or without ofloxacin, against Mycobacterium leprae in patients. Antimicrob Agents Chemother. 1996; 40 (9) 2137-2141
- 36 Ji B, Grosset J H. Ofloxacin for the treatment of leprosy. Acta Lepr. 1991; 7 (4) 321-326
- 37 Consigny S, Bentoucha A, Bonnafous P, Grosset J, Ji B. Bactericidal activities of HMR 3647, moxifloxacin and rifapentine against Mycobakterium leprae in mice. Antimicrob Agents Chemother. 2000; 44 (10) 2919-2921
- 38 Nakashima M, Uematsu T, Kanamaru M, Okazaki O, Hakusui H. Phase I study of levofloxacin,(s)-(-)-ofloxacin. Jpn J Clin Pharmacol Ther. 1992; 23 515-521
- 39 Dhople A M, Namba K. In vivo susceptibility of Mycobacterium leprae to sitafloxacin (DU-6859a), either singly or in combination with rifampicin analogues. Int J Antimicrob Agents. 2003; 21 (3) 251-255
- 40 Bharti R. Pefloxacin in leprosy. Indian J Lepr. 1994; 66 (4) 443-448
- 41 Chan G P, Garcia-Ignacio B Y, Chavez V E, Livelo J B, Jimenez C L, Parrilla M L, Franzblau S G. Clinical trial of sparfloxacin for lepromatous leprosy. Antimicrob Agents Chemother. 1994; 38 (1) 61-65
- 42 Gelber R H, Fukuda K, Byrd S, Murray L P, Siu P, Tsang M, Rea T H. A clinical trial of minocycline in lepromatous leprosy. Brit Med J. 1992; 304 (6819) 91-92
- 43 WHO Expert Committee on Leprosy .7th Report. Tech Rep Ser 874. Genf; World Health Organization 1998
- 44 Single-Lesion Multicentre Trial Group . Efficacy of single dose multidrug therapy for treatment of single-lesion paucibacillary leprosy. Indian J Lepr. 1997; 69 (2) 121-129
- 45 Gupta M D. Field trials with a single dose of the combination rifampicin-ofloxacin-minocycline (ROM) for the treatment of paucibacillary leprosy. Lepr Rev. 2000; 71 (Suppl.) S77-S80
- 46 Ustianowski A P, Lockwood D NJ. Leprosy: current diagnostic and treatment approaches. Curr Opin Inf Dis. 2003; 16 (5) 421-427
- 47 Daumerie D. Current World Health Organization sponsored studies in the chemotherapy of leprosy. Lepr Rev. 2000; 71 (Suppl.) S88-S90
- 48 WHO-Study Group .Chemotherapy of leprosy for control programmes. Tech Rep Ser 675. Genf; World Health Organization 1982
- 49 WHO study group .Chemotherapy of leprosy. Report of a WHO study group. Tech Rep Ser 847. Genf; World Health Organization 1994
- 50 WHO Expert Committee on leprosy .Tech Rep Ser 874. Genf; World Health Organization 1998
- 51 Technical Advisory Group on elimination of leprosy .Report on third meeting of the WHO Conclusions and recommendations. Report No. WHO/CDS/CPE/CEE 2002.29. Genf; World Health Organization 2002
- 52 Ji B, Saunderson P. Uniform MDT (U-MDT) regimen for all leprosy patients: another example of wishful thinking. Lepr Rev. 2003; 74 (1) 2-6
- 53 World Health Organization .Guide to Eliminate Leprosy as a Public Health Problem. WHO/CDS/CPE/CEE/2000.14. Genf; World Health Organization 2000
- 54 Ji B. Accompanied MDT (AMDT) - more questions than answers. Lepr Rev. 2002; 73 (4) 301-307
- 55 Jacobson R R. Needed research in chemotherapy of leprosy related to the individual patient. Int J Lepr Other Mycobact Dis. 1996; 64 (Suppl.) S16-S20
- 56 Curtiss R 3rd, Blower S, Cooper K, Russell D, Silverstein S, Young L. Leprosy research in the post-genome era. Lepr Rev. 2001; 72 (1) 8-22
-
57 Ridley D S.
Bacterial indices. In: Cochrane RG, Davey TF (Hrsg.) Leprosy in theory and practice. Bristol; 1964
1 Exazerbationen des ansonsten hoch chronischen Krankheitsverlaufes der Lepra werden als Reaktionen bezeichnet. Man unterscheidet die Typ I-Reaktion, welche durch einen - oftmals therapieinduzierten - Anstieg der zellvermittelten Immunität verursacht wird, von der Typ II-Reaktion (Erythema nodosum leprosum [ENL]), die man als ein durch Präzipitation von Ag/Ak-Komplexen verursachtes Immunkomplex-Syndrom auffasst. Typ I-Reaktionen kommen bei BT, BB- und BL-, selten auch bei TT-Fällen vor, Typ II-Reaktionen sind in aller Regel auf LL-, gelegentlich auch BL-Fälle beschränkt.
Dr. Christoph Bendick
Gotenring 33 · 50679 Köln
Email: soksabay@yahoo.com