Systematic reviews of historical evidence of the effectiveness of dapsone, acedapsone
, rifampicin and combinations of rifampicin, minocycline and ofloxacin had shown their effectiveness.
This is in line with the WHO recommendations, (3,4) that family members of leprosy patients should be given 1-4 mg dapsone per kilogram (kg/body weight per week) as well as one time intramuscularly injection of acedapsone
per 10 weeks interval as prophylactic treatment to protect household contacts.
Evidence that bacterial persistence might be a problem in the treatment of lepromatous leprosy, also, came from a study of the Karimui of Papua New Guinea in which five of 28 lepromatous patients were found to have solid-staining bacilli (indicative of live bacilli) in their skin smears despite regular treatment with acedapsone for 3-5 years and expected blood sulphone levels.
Experience with acedapsone (DADDS) in the therapeutic trial in New Guinea and the chemoprophylactic trial in Micronesia.
One systematic review and metaanalysis published in 2000 (a review that pooled two duplicated studies) found that prolonged administration of dapsone and acedapsone could prevent leprosy development in contacts by 40.
Two studies evaluating an acedapsone dose every 10 weeks for 7 months were included (43, 44).
44) assessed the effectiveness of acedapsone with placebo in contacts of patients with multibacillary leprosy.
Meta-analysis of these two studies significantly favored acedapsone to placebo (2 RCT, 1 259 participants, RR 0.
Acedapsone (43, 44) and rifampicin (38, 39) were more effective than placebo and also presented a significant reduction (between 67% and 57%, respectively) in the incidence of leprosy in patients' contacts.
The results confirm the findings of a previous meta-analysis, where the authors found that prolonged administration of dapsone and acedapsone (20, 21) could prevent the appearance of leprosy among contacts by 40% to 60% compared with placebo (10).