Effect of levamisole on clinical outcome and DNCB conversion in leprosy patients. A long term study

Fifteen patients of lepromatous leprosy within first 6 months of diagnosis were studied. 7 controls received standard DDS treatment and placebo while 8 patients received cyclical levamisole treatment (150 mg daily for 3 days repeated after a gap of 2 weeks), in addition to standard DDS treatment. Patients were followed up clinically for lepra reactions, serial B.I. and DNCB test for 2 years. We observed that ENL reactions were more common and more severe in levamisole treated group while an upgrading type reaction occurred only in one of the control patients. B I. remained same in both groups throughout, while DNCB score was higher in control rather than levamisole treated groups. Thus, levamisole treatment does not seem to have caused stimulation of CMI in our patients as judged by DNCB reaction while it may have caused stimulation of humoral immunity as seen by higher incidence of ENL reaction. This may be undesirable in lepromatous patients.