Dapsone Combination Therapy for Treatment of Chronic Lyme Disease

Richard Horowitz, MD
          Richard Horowitz, MD

A new study by Richard Horowitz, MD and Phyllis Freeman, MD has been published in Antibiotics that evaluates the efficacy of using short-term high dose pulsed dapsone combination therapy (HDDCT) in the treatment of Chronic Lyme disease/Post Treatment Lyme Disease Syndrome(PTLDS).

This new study builds upon past studies conducted by Dr. Horowitz et al. and included 25 patients that had history of Lyme and associated co-infections. These patients, most who had ongoing symptoms after several courses of double dose dapsone combination therapy, were trialed with one or more courses of HDDCT (200 mg dapsone × 3–4 days and/or 200 mg BID × 4 days), depending on their persistence of symptoms.

Study results showed that the majority of patients reported sustained improvement in “eight major Lyme symptoms, including:  fatigue, pain, headaches, neuropathy, insomnia, cognition, and sweating.”  Dapsone dosage, not just the treatment length, showed a positive effect on patient outcomes. The study shows the risk/benefit ratio of using four days of higher dose dapsone combination therapy is evidenced by 84% of patients noting improvement of their tick-borne disease symptoms. Thirty-two percent of patients had resolution of all active Lyme symptoms for 3-months or longer post HDDCT even if there was evidence of prior active co-infections. Forty-three percent of patients with an EM rash and history of PTLDS remained in remission,  and 57% of patients reported mild-moderate improvement in their underlying symptoms from their baseline.

Authors note that these findings should be confirmed in randomized, controlled clinical trials as cases of Lyme disease continue to escalate and curative treatments have not yet been attained for Chronic Lyme/PTLDS.  

Read the full text article here

Read additional LDA articles on Dapsone studies by Dr. Horowitz et al. here