PRFM or PRP therapy for trophic ulcers due to leprosy?

Both topical autologous platelet-rich fibrin (PRFM) with total contact cast and perilesional injectable autologous platelet-rich plasma (PRP) therapy with total contact cast reduced the surface area of trophic ulcers due to leprosy. As PRFM is more cost-effective and less resource-consuming, it may therefore be the preferred treatment option for these patients.

Prof. Amrita Sil (Rampurhat Government Medical College & Hospital, India) and her research team conducted a trial to compare PRFM and PRP therapy for patients with trophic ulcers due to leprosy [1]. They randomised 52 participants 1:1 to either of the 2 treatment groups and hypothesised that PRFM was non-inferior to PRP therapy.

The mean ulcer surface area decreased from 290.04 cm² at baseline to 152.77 cm² at the final follow-up visitation (week 10) in the PRFM group (P<0.05). For the PRP group, the corresponding numbers were 422.48 cm² and 247.84 cm² (P<0.05; see Table). Notably, no significant difference was observed between the mean changes in surface area of the 2 groups at week 10 (P=0.64). In the PRFM group, 2 adverse events were reported: 1 case of discoid dermatitis and 1 case of cellulitis. In the PRP group, 3 adverse events were observed: cellulitis, callosity, and maggot formation.

Table: Changes in surface area of trophic ulcers due to leprosy [1]

PRFM, platelet-rich fibrin; PRP, platelet-rich plasma; SD, standard deviation.

Prof. Sil summarised that both therapies were efficacious in reducing the surface area of the ulcers and that PRFM was non-inferior to PRP therapy. Since PRFM is less time-consuming and will generally lead to less blood loss than PRP therapy, this may be the preferred treatment option in patients with trophic ulcers due to leprosy.

1. Sil A, et al. Efficacy and safety of topical autologous platelet-rich-fibrin-membrane with total-contact-cast versus perilesional injectable autologous platelet-rich-plasma therapy with total-contact-cast in trophic ulcer due to leprosy: an observer-blind, randomised, active-controlled, non-inferiority trial. Late-breaker Session 3, WCD 2023, 3–8 July, Singapore, Singapore.