Long-term outcomes of thalidomide in refractory Crohn's disease.

Abstract

BACKGROUND:

Several open-label and retrospective studies have indicated that thalidomide may be beneficial in patients with refractory Crohn's disease (CD).

AIM:

To report our long-term experience with the use of thalidomide for adults with refractory Crohn's disease.

METHODS:

We conducted a retrospective study of long-term clinical and safety outcomes among adults treated with thalidomide for refractory Crohn's disease. Response was defined as a clinician's assessment of improvement after at least 7 days treatment of one or more of the following: bowel movement frequency, fistula output, rectal bleeding, abdominal pain, extraintestinal manifestations, or well-being. Remission required all of the following: <3 stools/day, no bleeding, abdominal pain or extraintestinal manifestations and increased well-being.

RESULTS:

Thirty-seven adults with refractory Crohn's disease were treated with thalidomide for a median of 4.4 months and followed up for a median of 58 months. Clinical response and remission rates were 54% and 19%, respectively. About 40% of patients were able to stop steroids. Response rates were higher for those treated with more than 50 mg/day (85%) than for those treated with a maximum of 50 mg/day (40%; P = 0.01). An adverse event occurred in 68% of patients. Approximately one-third of patients (38%) experienced neuropathy.

CONCLUSIONS:

Thalidomide appears to be safe and effective in some patients with refractory Crohn's disease. Although side effects may limit long-term use, thalidomide has potential to induce significant clinical responses.

• Authors: M E Gerich, J L Yoon, S R Targan, A F Ippoliti, E A Vasiliauskas
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 41 Issue 5 Pg. 429-37 (Mar 2015) ISSN: 1365-2036 [Electronic] England
• PMID: 25511905 (Publication Type: Journal Article)
• Copyright: © 2014 John Wiley & Sons Ltd.

Chemical References

• Immunosuppressive Agents
• Steroids
• Thalidomide

Topics

• Adult
• Crohn Disease (drug therapy)
• Dose-Response Relationship, Drug
• Female
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects, therapeutic use)
• Male
• Middle Aged
• Retrospective Studies
• Steroids (therapeutic use)
• Thalidomide (administration & dosage, adverse effects, therapeutic use)