Clinical trial with clofazimine in leprosy

This paper summarises our clinical experience with clofazimine in the treatment of 25 cases of reactive states of lepromatous and borderline leprosy and 7 lepromatous patients not responding to dapsone. Corticosteroids, which had to be given for the control of reactions, could be withdrawn and daspone therapy reintroduced during the period of administration of clofazimine. A schedule for the management of moderately severe reactions is recommended. The results of clofazimine treatment were also equally impressive in the group of patients, possibly harbouring dapsone resistant bacilli (in view of their lack of improvement in spite of administration of dapsone under controlled conditions). Clinical regression was associated with a fall in the mean levels of morphological index from 6.8 to 0.5. The need to realise the real indications of this highly useful drug in the treatment of leprosy is stressed.

Side effects of clofazimine therapy

84 patients of leprosy including 15 female patients were treated with Clofzimine on a predetermined dosage regimen. 76 of these were cases of recurrent lepra reaction; 4 cases of proven DDS resistance, 3 of these being complicated by lepra reaction; and 4 were cases of reactional state in Borderline leprosy near the lepromatous end of the spectrum. The common side effect in all cases consisted of red and dark skin pigmentation of varying intensity occuring within 10 weeks of the commencement of therapy. The intensity of the colour was proportionate to the density of the infiltration. Ichthyosis occurred in 66.6% of cases. While the pigmentation was accepted by the patients in general, 10% of the patients considered ichthyosis as stigmatising. While side effects like anorexia, diarrhoea, enlargement of lymph glands and liver, corneal xerosis and loss of weight were self correcting, severe gastrointestinal manifestation, i.e. severe abdominal pain, vomiting and diarrhoea were observed in 9 patients, 5 of whom were females. Mortality was high in the females. On an incidental finding the Isonizair reduced the severity of the manifestations, it was supplemented in 10 cases on Clofazimine therapy and was found to minimise the side effects and the pigmentation due to Clofazimine. Hydration therapy for the ichthyosis and instillation of normal saline and liquid paraffin for corneal xerosis were found to be very useful.

Corneal changes in patients treated with clofazimine

Fine, brownish lines, similar to chloroquine keratopathy, were observed in two of 19 psoriatic patients given clofazimine. There was no functional disturbance and the changes were reversible.

Clofazimine. A new agent for the treatment of pyoderma gangrenosum

Eight patients had pyoderma gangrenosum. They were given a phendimetrazine tartrate derivative, clofazimine (Lamprene [Britain]), which is a chemotherapeutic agent used mainly in certain mycobacterial infections and which also has phagocytosis-enhancing properties. The effect of this drug was remarkably good, with rapid healing of the lesions commencing 3 to 14 days after treatment was started. The mechanism for the effect of clofazimine in pyoderma gangrenosum is not known.