03081nas a2200445   4500000000100000008004100001260001700042653001500059653001000074653000900084653003200093653001000125653001600135653001200151653003000163653001600193653001100209653001100220653002300231653001200254653001000266653000900276653001600285653001300301653001200314100001300326700001100339700001100350700001500361700001400376700001300390700001300403700001900416700001400435245015700449300001100606490000600617520199800623022001402621       1986                            d  c1986 Oct-Dec10aAdolescent10aAdult10aAged10aAspartate Aminotransferases10aChild10aClofazimine10aDapsone10aDrug Therapy, Combination10aEthionamide10aFemale10aHumans10aLeprostatic Agents10aleprosy10aLiver10aMale10aMiddle Aged10aRifampin10aSenegal1 aMillan J1 aRoux G1 aLoko S1 aNaudin J C1 aBoucher P1 aBodian M1 aCamara M1 aMoreira-Diop T1 aGrosset J00a[Multi-drug therapy trials for leprosy in Senegal: first observations relative to liver tolerance of multibacillary patients. Therapeutic consequences].  a427-440 v43 a<p>The authors have studied tolerance of multibacillary patients to 4 MDT regimens. These 4 regimens consist of: One supervised part in which RMP-ETH combination in once-monthly administered; furthermore, in 2 of these regimens, is included one "starter phase" with daily doses of that combination for 2 months. One self-administered part during which CLO is associated either to DDS for new cases, or to ETH for relapses. Clinical Supervision: Out to 310 multibacillary patients, 7 cases of hepatitis with or without icterus, but no death due to the treatment. Interruptions of MDT have been temporary and have been observed in 0.9 to 5.6% of the patients according to the therapeutic regimen. Checking SGOT: The SGOT were abnormally high in 16.3% of the patients before treatment. These pre-existing liver damages do not favour the appearance of intolerance disorders. During MDT, abnormal increases in SGOT are observed in 27% of the patients but there is no exact correlation between the absorbed doses of ETH and the frequency in SGOT increases. The clinical or biological evidence of liver damages occur rather early (1st, 2nd month) in regimens with "starter phase", and later (4th-8th month) in those without "starter phase". But introduction of "Starter phase" does not increase the global frequency of such intolerance accidents. ETH combined with RMP, must be used under steady clinical and biological supervision. Recalling the results of a previous survey, the authors consider that a long duration of MDT is not necessary. For the multibacillary leprosy treatment, they propose a diphasic regimen, more easily applicable in the field than the WHO protocols. In this diphasic regimen, the only part which must be supervised is the initial "starter phase" of 2 month. It consists of daily administration of 3 antibacillary drug among which RMP and ETH. The second phase is a relay treatment using 2 drugs, CLO combined with DDS or ETH, self-administered until smear negativity.</p>  a0001-5938