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Etanercept in erythema nodosum leprosum
Julia Rocha Silva Santos1, Dâmia Leal Vendramini1, José Augusto da Costa Nery1,2
1Professor Rubem David Azulay Dermatology Institute, Santa Casa de Misericórdia do Rio de Janeiro (DPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil.
Anais Brasileiros De Dermatologia
|September 28, 2017
Summary
Etanercept effectively controlled recurrent erythema nodosum leprosum in a leprosy patient, allowing discontinuation of thalidomide. This offers a promising alternative for managing challenging leprosy reactions.
Area of Science:
- Immunology
- Dermatology
- Infectious Diseases
Background:
- Leprosy treatment faces challenges in managing reaction events, particularly recurrent erythema nodosum leprosum (ENL).
- Standard treatments like thalidomide and prednisone carry risks of long-term side effects.
- Limited therapeutic options exist for managing recurrent ENL.
Observation:
- A patient with lepromatous leprosy experienced recurrent ENL despite standard treatment.
- Previous literature suggested anti-TNF agents, specifically infliximab and etanercept, showed promise for ENL treatment.
- The patient was treated with etanercept for recurrent ENL.
Findings:
- Etanercept successfully controlled the patient's recurrent erythema nodosum leprosum over a 10-month follow-up period.
- Treatment with etanercept allowed for the discontinuation of thalidomide.
- Prednisone dosage was maintained at a low level (10 mg/day) during etanercept therapy.
Implications:
- Etanercept represents a potential therapeutic option for managing recurrent erythema nodosum leprosum in leprosy patients.
- This approach may reduce the need for long-term immunosuppressive therapies like thalidomide, thereby mitigating associated risks.
- Further research into anti-TNF agents for leprosy reactions is warranted.
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