Indicatioins for Thalidomide Therapy for Leprosy

Klüken, N; W, Wente

doi:10.1111/j.1365-4362.1974.tb01761.x

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…There has been a recent resurgence in the study of thalidomide for management of the complications of HIV and other diseases. In addition to its effect on degradation of TNF-␣ mRNA, thalidomide has a number of other anti-inflammatory and immunomodulatory properties (10). Studies with thalidomide for treatment of other HIV-related conditions such as Kaposi's sarcoma, chronic diarrhea, and mycobacterial disease are ongoing (16,18).…”

mentioning

confidence: 99%

Single-dose pharmacokinetics of thalidomide in human immunodeficiency virus-infected patients

Piscitelli

Figg

Hahn

et al. 1997

Antimicrob Agents Chemother

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The pharmacokinetics of thalidomide in nine human immunodeficiency virus-infected patients were studied. Single doses of thalidomide were well absorbed, with mean peak concentrations (+/- standard deviations) of 1.17 +/- 0.21 and 3.47 +/- 1.14 microg/ml in the 100- and 300-mg dosing groups, respectively, and the mean elimination half-life was approximately 6 h. Adverse effects were mild, with drowsiness being reported for seven of nine patients.

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mentioning

confidence: 99%

Single-dose pharmacokinetics of thalidomide in human immunodeficiency virus-infected patients

Piscitelli

Figg

Hahn

et al. 1997

Antimicrob Agents Chemother

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“…The mechanism of its action is not understood; however, an antibacterial effect was excluded by Sheskin and Sagher (l968b). The use of several thalidomide analogues in patients with ENL has led to contradictory results (Jiiger et al 1971;Kliiken & Wente 1974;Koch 1985;Sheskin 1978;Sheskin et al 1968a). …”

Section: Erythema Nodosum Leprosummentioning

confidence: 96%

Thalidomide in Human Immunodeficiency Virus (HIV) Patients

Günzler¹

1992

Drug Safety

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The sedative thalidomide was withdrawn from the market 30 years ago because of its teratogenic and neurotoxic adverse effects. The compound was later discovered to be extremely effective in the treatment of erythema nodosum leprosum, a complication of lepromatous leprosy. This effect is probably due to a direct influence on the immune system, because thalidomide possesses no antibacterial activity. The compound is presently used as an experimental drug in the treatment of a variety of diseases with an autoimmune character, including recurrent aphthosis of nonviral and nonfungal origin in human immunodeficiency virus (HIV) patients. This article reviews the most important chemical and pharmacokinetic properties of thalidomide. The possible mechanisms of the nonsedative effects of thalidomide with respect to the safety of its use in HIV patients are discussed. Because the mechanism of the immunomodulatory effect of thalidomide is unknown, the possibility that the administration of this compound will accelerate the deterioration of the immunological status of HIV patients cannot be excluded. Clinical evidence suggests that thalidomide may aggravate the condition of patients with preexisting peripheral neuropathy. Hypersensitivity reactions to thalidomide may occur more frequently in HIV patients than in other patient groups. Because of the teratogenic activity of thalidomide, reliable contraception must be provided to female patients of childbearing age. Before the introduction of thalidomide therapy to an HIV patient presenting with oral ulcers, a fungal or viral origin of the lesions should be excluded. Thalidomide should not be used in patients with preexisting HIV-related peripheral polyneuropathy, polyradiculopathy or encephalopathy. In patients experiencing a complete remission, the discontinuation of thalidomide treatment and its reintroduction in the case of a relapse are preferable to maintenance therapy.

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“…nor could any cffect upon endogenou, cor1ic0Mcroidproduc1ion be proved. Sala(in ( 15) con,idered the po:,s1bili1y of thalidomidc int<!rfering wi1h thc metaboli,m of vitamin 8 Kluken & Ventz (7) sugge,tcd a stabilizing cffec1 on lysosome membrancs similar to that produced by cor tico,teroids.…”

Section: Pharmacologymentioning

confidence: 99%