Methotrexate and Prednisolone studies in Erythema Nodosum Leprosum (MaPs in ENL)

Methotrexate and Prednisolone studies (MaPs) in ENL.  Leprosy remains a significant problem in many countries. Leprosy is caused by the bacterium Mycobacterium leprae. The treatment of the infection requires antimicrobial therapy for 6 or 12 months which is very effective. However, despite treatment of the infection many individuals will develop painful, inflammatory episodes which may cause permanent damage to nerves and other organs. This often causes permanent disability.  

The treatment of these inflammatory episodes is usually with steroids which have many adverse effects when given for the prolonged periods in the high doses required. Thalidomide which is effective is not widely available and is banned in many leprosy endemic countries.  We are conducting two double blind randomised clinical trials to determine if methotrexate (an immunosuppressant) improves the outcomes for individuals with these severe episodes of inflammation.