Montelukast in ENL Reaction

NCT ID: NCT00406861

Last Updated: 2006-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2009-06-30

Brief Summary

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Objective of the trial is to assess the safety and efficacy of Montelukast in treatment of Erythema Nodosum leprosum (ENL) reaction in multibacillary leprosy patients either in combination with prednisolone or alone.

Hypothesis is that montelukast will reduce the severity of ENL reaction in Multibacillary leprosy patients without causing an unacceptably high incidence of adverse effects.

Design is a multicentre hospital-based single-blind prospective trial for leprosy patients with ENL reaction. prior written consent will be taken from the patients who will undergo the trial.

Endpoints are decrease in severity of ENL and absence of new nerve function impairment

Detailed Description

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Leprosy is still a common medical problem in many countries including Bangladesh, and currently there are at least 3500 leprosy patients in this country at risk of ENL reaction, which is a distressing complication of Multibacillary (MB) leprosy liable to result in permanent disability if not well treated. The drug of choice is either prednisolone ( which often causes adverse effects especially with prolonged use) or thalidomide which is not available in Bangladesh.Clofazimine in high doses is recommended as an alternative but supplies are difficult to obtain. Hence the need for an alternative drug which could be used as a steroid sparing agent or an alternative to steroids in ENL reaction. Montelukast is a leukotriene inhibitor already available on the open market in this country as an immunomodulator, and a small clinical trial with zafirlukast ( very similar drug) suggested that drugs in this group may be effective for ENL.

This is a phase two trial to assess the safety and efficacy of montelukast as an alternative or supplementarry treatment for ENL reaction.

Eligible patients presenting to one of the participating hospitals with ENL reaction will be randomly allocated to one of three groups to receive prednisolone only or prednisolone plus montelukast or montelukast alone. Any patients who have major contra-indications to steroids will be put into a separate observational group and receive montelukast only.

Drug regimens are prednisolone starting at 40 mg od nd tapered over 12 weeks. Montelukast 10mg od for 16 weeks.

The patients will be monitored weekly for 8 weeks then monthly for 4 months.

At least 20 patients will be enrolled in each group.

The patients will be closely observed for adverse effects, and any who deteriorate will receieve additional steroid according to the protocol. Any who develop new nerve function impairment will be removed from the trial and given a full course of prednisolone.

Analysis will be done on an intention to treat basis and will look for any statistically significant difference in ENL score at 2 weeks, 12 weeks and 24 weeks, or a difference in the number of patients who develop new nerve function impairment, as well as the incidence and severity of any adverse effects in each group.

Conditions

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Erythema Nodosum Leprosum Leprosy

Keywords

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reaction ENL leprosy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Interventions

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montelukast in treatment of ENL reaction

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* MB leprosy
* ENL reaction
* age 15-65
* weight \>35kg
* patient willing to participate,including agrees to investigations and admission
* adequate past records
* no steroid received in past 4 weeks

Exclusion Criteria

* pregnant or breast feeding
* other active serious infection
* history of intolerance to concerned drug
* known or suspected immunodeficiency
* needs high dose steroid for other condition
* recent new nerve funcion impairment
* recent hepatitis or impaired liver function
* thrombocytopenia, moderate or severe renal impairment
* received high dose clofazimine in past 3 months
Minimum Eligible Age

15 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Leprosy Mission Bangladesh

OTHER

Sponsor Role lead

Principal Investigators

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Abdul H Salim, MBBS

Role: PRINCIPAL_INVESTIGATOR

Damien Foundation Bangladesh

Locations

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Danish Bangladesh Leprosy Mission Hospital

Nilphamari, Nilphamari, Bangladesh

Site Status

Countries

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Bangladesh

Central Contacts

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Abdul H Salim, MBBS

Role: CONTACT

Phone: 880173011135

Email: [email protected]

Cynthia R Butlin, MBBCh MRCGP

Role: CONTACT

Phone: 0551 61372

Email: [email protected]

Other Identifiers

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BMRCERC2004-2007627

Identifier Type: -

Identifier Source: org_study_id