Using rifapentine as a prophylaxis to prevent community spread of leprosy
|
Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by An Duc Thien Le |
Posted on June 14th, 2023
|
Leprosy is caused by the bacteria Mycobacterium leprae. Besides treating the index case, transmission can be prevented by prophylaxis. Dapsone and acedapsone had previously been used as prophylaxis, but their efficacy is low due to a long treatment period that causes poor adherence. Rifampin and rifapentine exhibit a strong bactericidal activity against Mycobacterium leprae; thus, a study had investigated their effectiveness as prophylaxis for leprosy.
The cluster-randomized, controlled trial was conducted in China that included 207 clusters of 7450 households which had a person with leprosy. They were randomly assigned to receive a single dose of either rifapentine, rifampin, or placebo. For contacts between the age of 10 and 14 years old, 450 mg of either rifapentine or rifampin was given. The dose was increased to 600 mg in contacts older than 15 years old. After 4 years of follow-up, the researchers observed that the incidence of leprosy in the groups treated with rifapentine was 84% lower than those who were treated with placebo. On the other hand, rifampin did not result in any additional protective effect. This difference in effectiveness can be attributed to the longer half life and a lower minimum inhibitory concentration than rifampin.
The cluster-randomized, controlled trial was conducted in China that included 207 clusters of 7450 households which had a person with leprosy. They were randomly assigned to receive a single dose of either rifapentine, rifampin, or placebo. For contacts between the age of 10 and 14 years old, 450 mg of either rifapentine or rifampin was given. The dose was increased to 600 mg in contacts older than 15 years old. After 4 years of follow-up, the researchers observed that the incidence of leprosy in the groups treated with rifapentine was 84% lower than those who were treated with placebo. On the other hand, rifampin did not result in any additional protective effect. This difference in effectiveness can be attributed to the longer half life and a lower minimum inhibitory concentration than rifampin.