Bedaquiline monotherapy may improve skin lesions in multibacillary leprosy patients, suggests study

This study randomized individuals with untreated multibacillary leprosy to be given bedaquiline monotherapy for 8 weeks in Brazil. Following the 8-week bedaquiline treatment, the patients began normal multidrug therapy for leprosy, as defined by the WHO, and were monitored for 112 weeks. The change from baseline in the probabilities of Mycobacterium leprae growth in mice footpads following 8 weeks of bedaquiline medication was the main outcome measure. Changes in leprosy clinical signs and symptoms as well as M. leprae molecular viability (as determined by a quantitative reverse transcriptase–polymerase chain reaction test) were among the exploratory end goals.

The modified intention-to-treat analysis comprised 9 patients in total. After 4 weeks of bedaquiline monotherapy, the probabilities of positive M. leprae growth had dropped from 100% in all patients at baseline to 0.

All skin lesions of the patients looked better after 7 weeks of therapy than they had at the beginning. During therapy, 7 patients experienced at least one adverse event, all of which were grade 1 or 2. Overall, in individuals with multibacillary leprosy, bedaquiline therapy eliminated Mycobacterium leprae after four weeks of treatment.

Source:

Barreto, J., Sammarco Rosa, P., Adams, L., Aguilar, Z., Bakare, N., Chaplan, S. R., Akli, R. D., Ernault, E., Kulke, S., Lounis, N., Millington, D., Palmer, J. A., Remmerie, B., Wang, M., Young, S., Truman, R., & Rebello, P. F. B. (2024). Bedaquiline monotherapy for multibacillary leprosy. The New England Journal of Medicine, 391(23), 2212–2218. https://doi.org/10.1056/NEJMoa2312928