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Intolerance to Leprosy Multi-Drug Therapy: More Common in Women?
Kathryn Margaret Dupnik
  Kathryn Margaret Dupnik
Affiliation
Division of Infectious Diseases and Center for Global Health, Weill Cornell Medical College, New York, NY, USA
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a
Fernando José Ramos Cardoso
  Fernando José Ramos Cardoso
Affiliation
Giselda Trigueiro Hospital, Natal, RN, Brazil
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b
Ana Luiza Braga Brito de Macêdo
  Ana Luiza Braga Brito de Macêdo
Affiliation
Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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c
Igor Leonardo Cardoso de Sousa
  Igor Leonardo Cardoso de Sousa
Affiliation
Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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c
Renata Cristina Barros Leite
  Renata Cristina Barros Leite
Affiliation
Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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c
Selma Maria Bezerra Jerônimo
  Selma Maria Bezerra Jerônimo
Affiliation
Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
National Institute of Science and Technology (INCT/DT), Natal, RN, Brazil
Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, RN, Brazil
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c,d,e
Mauricio Lisboa Nobre
  Mauricio Lisboa Nobre
Affiliation
Giselda Trigueiro Hospital, Natal, RN, Brazil
National Institute of Science and Technology (INCT/DT), Natal, RN, Brazil
Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, RN, Brazil
Post-graduate Program in Tropical Medicine, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
Correspondence to: Mauricio Lisboa Nobre, Hospital Giselda Trigueiro, Rua Conego Monte, 110, Quintas, Natal, RN 59037-170, Brazil (Tel: +55-84-3615-5454; e-mail: nobreml@gmail.com)
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b,d,e,f,*
Objectives:

The objective was to characterise and identify potential risk factors for intolerance to multi-drug leprosy therapy (MDT) which prompted a medication change in a leprosy referral centre in northeastern Brazil.

 Design:

A retrospective chart review of leprosy patients treated at a state referral centre for leprosy in Natal, Rio Grande do Norte, Brazil was completed. Chart review focus was on adverse effects necessitating modification of MDT regimen.

 Results:

Six hundred and twelve records were reviewed with detection of 91 (14.8%) adverse effects with associated change in MDT regimen. The most common recorded causes of medication intolerance were anemia (8.7%), headache (4.2%), cyanosis (1.8%), and gastrointestinal symptoms (1.6%). Both female gender (OR = 2.63) and age less than 42 years old (OR = 2.7) remained risk factors for MDT intolerance in a multivariate model including gender, age, and WHO regimen type. With intolerance due to anemia as the outcome, female gender (OR = 2.36) and age less than 42 years (OR = 1.86) were associated.

 Conclusions:

In this study, female gender and younger age were associated with greater risk of medication intolerance and medication intolerance related to anemia. These findings have important operational implications for drug intolerance monitoring during therapy for leprosy.
Cite this article
Kathryn Margaret Dupnik, Fernando José Ramos Cardoso, Ana Luiza Braga Brito de Macêdo, Igor Leonardo Cardoso de Sousa, Renata Cristina Barros Leite, Selma Maria Bezerra Jerônimo, Mauricio Lisboa Nobre;
Intolerance to Leprosy Multi-Drug Therapy: More Common in Women?; Leprosy Review; 2013; 84; 3; 209-218; DOI: 10.47276/lr.84.3.209
home.article_information

DOI: 10.47276/lr.84.3.209

articleview.journal_title: Leprosy Review
articleview.publisher: British Leprosy Relief Association
articleview.publisher_location: Colchester, UK
articleview.article_date_pre accepted on 01 October 2013 and articleview.pub_on 01 September 2013
© Lepra 2013
LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
20-9218
0305-7518/13/064053+10
10.47276/lr.84.3.209
Original Papers
Intolerance to Leprosy Multi-Drug Therapy: More Common in Women?
DupnikKathryn Margaret
a
CardosoFernando José Ramos
b
de MacêdoAna Luiza Braga Brito
c
de SousaIgor Leonardo Cardoso
c
LeiteRenata Cristina Barros
c
JerônimoSelma Maria Bezerra
cde
NobreMauricio Lisboa
bdef
a
Division of Infectious Diseases and Center for Global Health, Weill Cornell Medical College, New York, NY, USA
b
Giselda Trigueiro Hospital, Natal, RN, Brazil
c
Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
d
National Institute of Science and Technology (INCT/DT), Natal, RN, Brazil
e
Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, RN, Brazil
f
Post-graduate Program in Tropical Medicine, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
Correspondence to: Mauricio Lisboa Nobre, Hospital Giselda Trigueiro, Rua Conego Monte, 110, Quintas, Natal, RN 59037-170, Brazil (Tel: +55-84-3615-5454; e-mail: )
01092013
84
3
209
218
01102013
© Lepra
2013
Objectives:
The objective was to characterise and identify potential risk factors for intolerance to multi-drug leprosy therapy (MDT) which prompted a medication change in a leprosy referral centre in northeastern Brazil.
Design:
A retrospective chart review of leprosy patients treated at a state referral centre for leprosy in Natal, Rio Grande do Norte, Brazil was completed. Chart review focus was on adverse effects necessitating modification of MDT regimen.
Results:
Six hundred and twelve records were reviewed with detection of 91 (14.8%) adverse effects with associated change in MDT regimen. The most common recorded causes of medication intolerance were anemia (8.7%), headache (4.2%), cyanosis (1.8%), and gastrointestinal symptoms (1.6%). Both female gender (OR = 2.63) and age less than 42 years old (OR = 2.7) remained risk factors for MDT intolerance in a multivariate model including gender, age, and WHO regimen type. With intolerance due to anemia as the outcome, female gender (OR = 2.36) and age less than 42 years (OR = 1.86) were associated.
Conclusions:
In this study, female gender and younger age were associated with greater risk of medication intolerance and medication intolerance related to anemia. These findings have important operational implications for drug intolerance monitoring during therapy for leprosy.