A study of standardized regimens of steroid treatment in reactions in leprosy at a referral centre.

It is a well known fact that reactions and nerve function impairment (NFI) account for majority of disabilities and morbidities in leprosy. Steroids are the principal agents administered for treatment of reactions and NFI. In this study, we compared the efficacy of two regimens namely high dose (60 mg) regimen tapered over 28 weeks and low dose (40 mg) regimen tapered over 22 weeks in treatment of reactions and early NFI as regards to incidence of recurrence of reactions in 209 patients. Concerns about the side-effects of steroids were also addressed byfollowing a strict pre-steroid investigation protocol. We observed that the low dose regimen was associated with a higher incidence of recurrence (48.3%) as compared to high dose regimen (16%) signifying the efficacy of longer duration of therapy with a higher starting dose. No patient developed side-effects which necessitated withdrawal of steroids. Early detection with prompt and adequate therapy with proper dose and duration is the key to reduce recurrence of reactions and to minimize deformities due to reactions and NFI in leprosy.