Clofazimine: new products. Major antileprous drug

(1) Clinical trials have shown that clofazimine monotherapy is effective. To avoid the emergence of resistance, however, the WHO reference treatment since 1982 has been the rifampicin + dapsone + clofazimine combination. (2) Epidemiological studies show that this polychemotherapy regimen is effective, but we do not yet know if treatment should be continued until skin smears become negative, or whether a 2-year course suffices. (3) Adding clofazimine to the polychemotherapy regimen partly prevents and also lessens the intensity of lepra reactions. However, in the absence of comparative trials, we do not know the part played by clofazimine in the efficacy of the WHO-recommended three-drug regimen. (4) The main adverse effects of clofazimine arise from its accumulation in the skin and eyes, where it frequently causes hyperpigmentation that resolves very slowly on treatment cessation.