Objective: The World Health Organization (WHO) recommends multidrug therapy (MDT) with rifampicin, dapsone, and clofazimine for treating leprosy, which is based on very low-quality evidence. Here, we performed a network meta-analysis (NMA) to produce quantitative evidence to strengthen current WHO recommendations. Method: All studies were obtained from Embase and PubMed from the date of establishment to October 9, 2021.Data were synthesized with frequentist random-effects network meta-analyses. Outcomes were as-sessed using odds ratios (ORs), 95% confidence intervals (95% CIs), and P score.Results: Sixty controlled clinical trials and 9256 patients were included. MDT was effective (range of OR: 1.06-1255584.25) for treating leprosy and multibacillary leprosy. Six treatments (Range of OR: 1.199-4.50) were more effective than MDT. Clofazimine (P score=0.9141) and dapsone+rifampicin (P score=0.8785) were effective for treating type 2 leprosy reaction. There were no significant differences in the safety of any of the tested drug regimens.Conclusions: The WHO MDT is effective for treating leprosy and multibacillary leprosy, but it may not be effective enough. Pefloxacin and ofloxacin may be good adjunct drugs for increasing MDT efficacy. Clofazimine and dapsone+rifampicin can be used in the treatment of a type 2 leprosy reaction. Single-drug regimens are not efficient enough to treat leprosy, multibacillary leprosy, or a type 2 leprosy reaction. Availability of data and materials: All data generated or analyzed during this study are included in this published article [and its supplementary information files].(c) 2023 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
[1]Kunming Med Univ, Inst Trop Med, Evidence Based Med Team, Kunming 650500, Yunnan, Peoples R China.
[2]Kunming Med Univ, Affiliated Children Hosp, Yunnan Prov Key Lab Childrens Major Dis Res, Kunming 650030, Yunnan, Peoples R China.
[3]Monash Univ, Biomed Discovery Inst, Dept Biochem & Mol Biol, Melbourne, Vic 3800, Australia.
[4]Kunming Med Univ, Yunnan Canc Hosp, Inst Oncol, Kunming 650100, Yunnan, Peoples R China.
(8.0+极速模式)