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Corticosteroids for treating nerve damage in leprosy

Van Veen NHJ, Nicholls PG, Smith WCS, Richardus JH
Published Online: 
10 August 2011

Leprosy is a chronic infectious disease. Leprosy bacteria cause damage to skin and peripheral nerves which may result in nerve function impairment and disability. Corticosteroids, especially prednisolone, are commonly used for treating nerve damage although their long-term effect is uncertain. Three randomised controlled trials, involving 513 people, were included in the review. Risk of bias was generally low in the three trials. Two of the included trials compared prednisolone with placebo. One trial with 84 participants treated mild sensory impairment of less than six months duration and the other trial, which had 95 participants, treated nerve function impairment of 6 to 24 months duration. Twelve months after the start of treatment, there was no significant difference in nerve function improvement between people treated with prednisolone or with placebo. The third trial compared three corticosteroid regimens for severe type 1 reactions 12 months from the start of treatment in 334 participants. After 12 months, significantly more individuals on a three-month course of prednisolone required extra corticosteroids compared to the groups with a high-dose and low-dose regimen of five months duration. Diabetes and peptic or infected ulcer were sometimes reported as serious adverse events, but did not occur significantly more often in corticosteroid than placebo groups.

This record should be cited as: 
Van Veen NHJ, Nicholls PG, Smith WCS, Richardus JH. Corticosteroids for treating nerve damage in leprosy. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005491. DOI: 10.1002/14651858.CD005491.pub2
Assessed as up to date: 
17 January 2011