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Evidence summaries

Corticosteroids for Nerve Damage in Leprosy

Prednisolone appears not to improve nerve function in patients with sensory impairment in leprosy. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 5 studies with a total of 576 subjects. Two out of the five trials reported on improvement in nerve function at one year. These two trials compared prednisolone with placebo. One trial treated mild sensory impairment of less than six months duration and the other trial treated nerve function impairment of 6 to 24 months duration. Both trials examined an effect twelve months from the start of treatment. There was no significant difference in nerve function improvement between people treated with prednisolone or with placebo. The other three trials did not report on the primary outcome measure. One trial compared three corticosteroid regimens for severe type 1 reactions. This trial did not report the prespecified outcomes. Another trial (21 participants) compared low-dose prednisone with high-dose prednisone for ulnar neuropathy. Two participants on the higher dose of prednisone reported adverse effects. The last (42 participants) compared intravenous methylprednisolone and oral prednisolone with intravenous normal saline and oral prednisolone. The trial found no significant differences between the groups in the occurrence of adverse events.

Comment: The quality of evidence is downgraded by inconsistency of results; heterogeneity in interventions and outcomes.

    References

    • Van Veen NH, Nicholls PG, Smith WC et al. Corticosteroids for treating nerve damage in leprosy. Cochrane Database Syst Rev 2016;(5):CD005491. [PubMed]

Primary/Secondary Keywords