Methotrexate and Prednisolone Study in Erythema Nodosum Leprosum (MaPS in ENL
Erythema Nodosum Leprosum (ENL) is a painful, debilitating complication of leprosy. Patients often require high doses of corticosteroids for prolonged periods. Thalidomide is expensive and not available in most countries. The use of corticosteroids for long periods is associated with adverse effects and mortality. It is a priority to identify alternative agents to treat ENL. Methotrexate (MTX) is a cheap, widely used medication which has been reported to be effective in ENL resistant to steroids and thalidomide.
• Individuals who diagnosed with leprosy complicated by ENL
• Individuals with ENL aged 18-60 years old
• Individuals with ENL deteriorating symptoms
• Individuals with 10 or more tender, papular or nodular ENL skin lesions
• Individuals with an EESS score of at least 9
• Individuals with ENL on:
‣ No current anti- ENL treatment
⁃ Prednisolone up to 30mg per day (if ACUTE) or Prednisolone 10-30mg (inclusive) per day (if RECURRENT/ CHRONIC) or equivalent alternative corticosteroid dose OR
⁃ Thalidomide or other non-steroidal anti-ENL medication OR
⁃ A combination of prednisolone (up to 30mg) and another non-steroidal anti-ENL medication (thalidomide, clofazimine, azathioprine, pentoxifylline, ciclosporin, minocycline)