Comparison of MRM-C and WHO-MDT Regimens in Multibacillary Leprosy: A Retrospective Cohort Study
Abstract
Background: The WHO-recommended multidrug therapy (MDT) has been effective in the treatment of leprosy; however, adverse drug reactions, particularly due to dapsone, complicate management in resource-limited settings. To address these challenges, an alternative regimen, MRM-C (moxifloxacin, rifampicin, minocycline, clofazimine), was introduced in 2014 at the Marie Adelaide Leprosy Centre (MALC).
Objective: To compare the clinical efficacy and safety profile of the MRM-C regimen with the standard WHO-MDT regimen in multibacillary (MB) leprosy patients.
Methodology: This retrospective cohort study included 100 newly diagnosed MB leprosy patients treated between January 2014 and December 2018 at MALC, Karachi, in collaboration with the Dermatology Department of Dow University of Health Sciences/Dr. Ruth K.M. Pfau Civil Hospital. Fifty patients received the MRM-C regimen and fifty received WHO-MDT, with treatment duration ranging from 12 to 24 months and a five-year follow-up until December 2023. Clinical outcomes and adverse events were assessed. Statistical analyses were conducted using t-tests and Fisher’s exact test, with p < 0.05 considered significant.
Results: Both regimens showed comparable efficacy, with over 98% of patients achieving clinically inactive disease after five years of follow-up (p = 1.000). However, adverse effects were significantly lower in the MRM-C group (4%) compared to the WHO-MDT group (36%), with anemia being the most frequent in the latter (p =…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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