Adding Lamprene to current tuberculosis therapy demonstrated higher treatment success than standard treatment alone in treating multidrug-resistant tuberculosis, researchers in China have found.
“Our study demonstrated that clofazimine-containing chemotherapy for the treatment of MDR-TB can promote cavity closure, accelerate sputum culture conversion and improve treatment success rates,” the researchers wrote in Clinical Infectious Diseases. “Clofazimine appears to be associated with a lower incidence of serious adverse effects compared with other second-line therapeutics, suggesting that clofazimine could potentially be considered as an additional therapeutic agent for the treatment of MDR-TB.”
The researchers, from the Tuberculosis Multi-Disciplinary Diagnosis and Treatment Center at Beijing Chest Hospital and the Tuberculosis Center for Diagnosis and Treatment at Shanghai Pulmonary Hospital, conducted a prospective, randomized, controlled open study at six TB specialized hospitals in China. The patients were randomly assigned to 21 months of TB chemotherapy regimens containing at least five drugs recommended by WHO with or without 100 mg Lamprene (clofazimine, Novartis) once daily.
The study included 105 patients with MDR-TB. Fifty-three patients were assigned to the clofazimine group. The time to sputum conversion to negative was quicker among patients who received clofazimine (P = .042). Chest CT showed that cavity closure was earlier among patients who received clofazimine (P = .047). The rate of treatment success was 73.6% among patients in the clofazimine group vs. 53.8% in the control group (P = .035).
Only patients in the clofazimine group experienced skin adverse events: 94.3% experienced skin discoloration and 47.2% experienced ichthyosis. Other adverse events were similar between groups.
“The reddish-brown discoloration seen in skin and conjunctiva were gradually reversible on cessation of therapy, as reported,” the researchers wrote. “However, [previous research] noted that patients suffered from depression due to skin discoloration. Therefore, depending on the extent of the skin discoloration, it might be prudent to provide additional psychosocial support to patients undergoing clofazimine treatment.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.