Scenarios warranting modified treatment regimens in leprosy: A 5-year retrospective study from a tertiary care center

To study the scenarios warranting modified treatment regimens in leprosy. A 5-year retrospective study was carried out in a tertiary care center by analyzing the data collected from national leprosy eradication program (NLEP) records. During the 5-year study period, 171 patients received treatment for leprosy from our center. Thirtyone patients (31/171, 18.1%) required substitution of standard multidrug therapy (MDT) with alternate drugs or required alternate treatment regimens. The patients who required modified treatment included 18 men (18/31, 58.1%) and 13 women (41.9%). Male/female ratio was 1.4:1. Indications for treatment modification were adverse drug reactions to standard MDT (ADR) (21/31, 67.7%) and lack of response to standard MDT (10/31, 32.3%). The most common scenario that warranted a modification of standard MDT was dapsone-induced hemolysis (12/31, 38.7%). Seven (7/31, 22.6%) and two (2/31, 6.5%) patients needed a change in treatment due to drug-induced hepatitis and drug-induced maculopapular rash, respectively. Retrospective study design, study conducted in single tertiary referral center and small sample size were the limitations. Nearly one-fifth of patients with leprosy required modifications in standard MDT. The most common indication (in two-third of patients who needed a modified treatment) for modification of treatment regimen was adverse drug reactions.