Type II reaction in
leprosy, or
erythema nodosum leprosum (ENL), is often characterized by severe clinical symptoms together with nerve function impairment leading to permanent disabilities.
Thalidomide has been shown to be a highly effective
drug for the treatment of ENL. It is, however, contraindicated for women of childbearing age due to its teratogenicity. On the other hand,
pentoxifylline, used to treat hypercoagulable states, is not teratogenic and, like
thalidomide, can inhibit the synthesis of
tumor necrosis factor-a and other
cytokines. In the present randomized double-blind clinical study we compared the effectiveness of orally administered
pentoxifylline vs
thalidomide in treating type II reaction in 44 patients. Daily doses of 300 mg
thalidomide or 1.2 g
pentoxifylline were administered for 30 days to
multibacillary leprosy patients undergoing type II reaction. Randomly chosen patients were included in the study before, during, and after specific multidrug
therapy. Clinical evaluations were performed on the 1st, 7th, 14th, 21st, and 30th days of treatment and laboratory tests were carried out on the 1st and 30th days. As expected, overall,
thalidomide proved to be more effective in the treatment of type II
leprosy reaction. Nevertheless, continuous treatment with
pentoxifylline was effective in relieving the clinical signs of ENL, especially limb
edema and systemic symptoms, in 62.5% of the patients.