{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:55:56Z","timestamp":1782838556093,"version":"3.54.5"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medicine"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Main therapy for leprosy reactions is 12\u2009weeks corticosteroids according to World Health Organization recommendations, but recovery cannot be achieved and recurrence occurs. Long duration of administration was thought to provide better clinical improvement. Evidence of the efficacy of corticosteroids in leprosy reactions is still lacking, and optimal dose and duration of therapy vary, while the need for long-term high-dose corticosteroids makes it difficult to avoid adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective cohort study analyzing the difference between therapeutic effectiveness and adverse effects of 12\u2009weeks and &gt;12\u2009weeks corticosteroids, involving all new leprosy patients without age restriction, at Cipto Mangunkusumo Hospital and Cakung Community Health Center in Indonesia during 1 January 2015\u201331 December 2017. Secondary data were collected from medical records, and observations carried out until December 2018. Therapeutic effectiveness was assessed from clinical improvement to corticosteroids discontinuation, without 3\u2009months recurrence after first cycle was completed. Adverse effects were assessed by all corticosteroids-related side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 195 patients, 57 (29.2%) used 12\u2009weeks corticosteroids, and 138 (70.8%) for &gt;12\u2009weeks. Effectiveness occurred in 38 (66.7%) of 12\u2009weeks group and 106 (76.8%) of &gt;12\u2009weeks group (relative risk\u2009=\u20090.604, 95% confidence interval\u2009=\u20090.307\u20131.189, p\u2009=\u20090.143). Of 145 patients, adverse effects occurred in 12 (31.6%) of 12\u2009weeks group and 70 (65.4%) of &gt;12\u2009weeks group (relative risk\u2009=\u20090.244, 95% confidence interval\u2009=\u20090.111\u20130.538, p\u2009&lt;\u20090.001). Of 171 adverse effects, 37.4% were mild such as dyspepsia, skin disorders, and lipodystrophy, while 62.6% were severe in the form of neuropsychiatric disorders, eye disorders, cardiovascular disease, gastrointestinal bleeding, metabolic-hormonal abnormalities, and reactivation of infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is no effectiveness difference in the form of clinical improvement without 3\u2009months recurrence, between 12\u2009weeks and &gt;12\u2009weeks corticosteroid, while longer administration causes 4 times more events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121221089448","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T05:28:38Z","timestamp":1650346118000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of therapeutic effectiveness and adverse effects of long-term corticosteroids among leprosy patients with reactions: A retrospective cohort study"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8964-4811","authenticated-orcid":false,"given":"Joyce Novelyn","family":"Siagian","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Purwantyastuti","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Instiaty","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri Linuwih","family":"Menaldi","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine, University of Indonesia and Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"bibr1-20503121221089448","first-page":"73","volume-title":"Dermatology and venereology","author":"Kosasih A","year":"2011","edition":"6"},{"key":"bibr2-20503121221089448","volume-title":"Clinical practice guidelines for dermatologists and venereologists in Indonesia","author":"Indonesian Society of Dermatology &amp; Venereology","year":"2017"},{"key":"bibr3-20503121221089448","volume-title":"National guidelines for leprosy control program","author":"Indonesian Ministry of Health","year":"2012"},{"key":"bibr4-20503121221089448","volume-title":"Indonesia Health Profile in 2016","author":"Indonesian Ministry of Health","year":"2017"},{"key":"bibr5-20503121221089448","unstructured":"WHO expert committee on leprosy: 8th report\n                      . 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