Abstract | BACKGROUND: Several open-label and retrospective studies have indicated that thalidomide may be beneficial in patients with refractory Crohn's disease (CD). AIM: 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.
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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)
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Copyright | © 2014 John Wiley & Sons Ltd. |
Chemical References |
- Immunosuppressive Agents
- Steroids
- Thalidomide
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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)
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