The Group further felt that if all other conditions were similar, shorter regimens are preferred. It was also agreed that even beyond the year 2000, MDT should be made available in blister packs and cost factors should not limit the provision of good quality medicines.
It was agreed that if newer regimens become available with more or less equal efficacy but with a similar duration of therapy, there might be little advantage in changing from presently available and recommended WHO MDT.
It was stressed that results of clinical trials, should be reported giving information on efficacy and issues related to side effects, reactions and neuritis. Efficacy decisions should be based on clinical and bacteriological improvement and more importantly taking into account relapses. When deciding on implementation of such newer regimens all the above elements should be considered. Furthermore as regimens become shorter, the likelihood that complications of the disease will more frequently occur post-treatment may increase and if clofazamine is excluded from such regimens the frequency of ENL may rise. Planning for implementation of such regimens should also take these factors into consideration. Cost of such regimens must of course also be considered as well as operational factors.
R. Jacobson, GW Long Hansen's Disease Center, LA, U.S.A
