Effectiveness and safety of multidrug therapy containing clofazimine for paucibacillary leprosy and clarithromycin for rifampicin-resistant leprosy: a systematic review and meta-analysis

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Autor(es): dc.contributorHealth Technology Assessment Unit, Hospital Alemão Oswaldo Cruz-
Autor(es): dc.contributorInstituto de Medicina Tropical de São Paulo, Universidade de São Paulo-
Autor(es): dc.contributorMinistério da Saúde do Brasil, Coordenação-Geral de Vigilância das Doenças em Eliminação-
Autor(es): dc.contributorMinistério da Saúde do Brasil, Coordenação-Geral de Vigilância das Doenças em Eliminação-
Autor(es): dc.contributorUniversidade de Brasília, Programa de Pós-Graduação em Ciências Médicas-
Autor(es): dc.contributorMinistério da Saúde do Brasil, Coordenação-Geral de Vigilância das Doenças em Eliminação-
Autor(es): dc.contributorUniversidade de Brasília, Programa de Pós-Graduação em Ciências Médicas-
Autor(es): dc.contributorUniversidade de Brasília, Programa de Pós-Graduação em Patologia Molecular-
Autor(es): dc.creatorMontezuma, Thais-
Autor(es): dc.creatorVernal, Sebastian-
Autor(es): dc.creatorAndrade, Elaine Nascimento-
Autor(es): dc.creatorBrandão, Jurema Guerrieri-
Autor(es): dc.creatorOliveira, Gustavo Laine Araújo de-
Autor(es): dc.creatorGomes, Ciro Martins-
Data de aceite: dc.date.accessioned2024-07-24T13:24:57Z-
Data de disponibilização: dc.date.available2024-07-24T13:24:57Z-
Data de envio: dc.date.issued2023-10-24-
Data de envio: dc.date.issued2023-10-24-
Data de envio: dc.date.issued2023-05-10-
Fonte completa do material: dc.identifierhttp://repositorio2.unb.br/jspui/handle/10482/46737-
Fonte completa do material: dc.identifierhttps://doi.org/10.3389/fmed.2023.1139304-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/capes/850930-
Descrição: dc.descriptionIntroduction: The present study aimed to evaluate leprosy cure and relapse rates as primary outcomes related to two additional strategies for leprosy treatment: clofazimine for paucibacillary (PB) leprosy patients and clarithromycin for patients with rifampicin-resistant leprosy. Methods: We conducted two systematic reviews (protocols CRD42022308272 and CRD42022308260). We searched the PubMed, EMBASE, Web of Science, Scopus, LILACS, Virtual Health Library and Cochrane Library databases, registers of clinical trial databases and gray literature. We included clinical trials evaluating the addition of clofazimine to PB leprosy treatment and the use of clarithromycin for treating patients with rifampicin-resistant leprosy. Risk of bias (RoB) in randomized clinical trials was assessed by the RoB 2 tool and that in non-randomized clinical trials was assessed by the ROBINS-I tool; and the certainty of the evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. A meta-analysis of dichotomous outcomes was performed. Results: For clofazimine, four studies were included. Cure and relapse rates were not dierent with the addition of clofazimine to PB leprosy treatment and demonstrated very low certainty of evidence. For clarithromycin, six studies were included. Considerable heterogeneity resulted from the dierence between comparators, and studies showed no dierence in the assessed outcomes with the addition of clarithromycin to rifampicin-resistant leprosy treatment. Mild adverse events were reported for both drugs but did not significantly impact treatment. Discussion: The eectiveness of both drugs still needs to be determined. Adding clofazimine to PB leprosy treatment may reduce the repercussions of an incorrect operational classification with no apparent relevant side.-
Descrição: dc.descriptionFaculdade de Medicina (FM)-
Formato: dc.formatapplication/pdf-
Idioma: dc.languageen-
Publicador: dc.publisherFrontiers-
Direitos: dc.rightsAcesso Aberto-
Direitos: dc.rightsCOPYRIGHT © 2023 Montezuma, Vernal, Andrade, Brandão, de Oliveira and Gomes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these term-
Palavras-chave: dc.subjectHanseníase-
Palavras-chave: dc.subjectMeta-análise-
Palavras-chave: dc.subjectResistência a medicamentos-
Título: dc.titleEffectiveness and safety of multidrug therapy containing clofazimine for paucibacillary leprosy and clarithromycin for rifampicin-resistant leprosy: a systematic review and meta-analysis-
Tipo de arquivo: dc.typeArtigo-
Aparece nas coleções:Repositório Institucional – UNB (old)

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