Treatment with corticosteroids of long-standing nerve function impairment in leprosy: a randomized controlled trial (TRIPOD 3)


J. H. Richardus, S. G. Withington, A.M. Anderson, R. P. Croft, P. G. Nicholls, W.H. van Brakel, W.C.S. Smith

Nerve Function Impairment (NFI) in leprosy patients may lead to severe disabilities, such as muscle paralysis of face, hands and feet, and chronic plantar and palmar ulceration. For many years, the mainstay of treatment of NFI of less than 6 months duration, in particular in the presence of clinically manifest type 1 reaction, has been with corticosteriods. For NFI of longer than 6 months duration, however, this treatment is not recommended. Beyond 6 months of NFI, never fibres are considered to be damaged irreversibly, and are therefore unlikely to respond to treatment. Yet there are indications that some patients with long-standing NFI have responded favourably to treatment with corticosteriods.