Recurrent aphthous ulcer in patient infected with human immunodeficiency virus: Successful treatment with thalidomide

Radeff, B; Küffer, R; Samson, Jacky

doi:10.1016/s0190-9622(08)81115-2

Cited by 39 publications

(9 citation statements)

References 10 publications

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“…(5) Patient was started on Thalidomide therapy in a dose of 100 mg three times daily for a period of 12 weeks. Within a week of initiation of treatment, dramatic response was noted in the healing of ulcer with gradual improvement in the clinical presentation over the next few weeks.…”

Section: Case Reportmentioning

confidence: 99%

Thalidomide: A Therapeutic Boon in the Management of Recurrent Genital Aphthous Ulceration in an Immunocompromised Individual

Madhubabu¹,

Padmaja²,

T³

et al. 2016

jemds

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Genital lesions are common in Human Immunodeficiency Virus (HIV) positive patients. Aetiology of the genital lesions are mainly due to Herpes Simplex Virus (HSV), Human Papilloma Virus (HPV) and non-specific genital ulcers. They usually respond to the antiviral and antibacterial agents. We are presenting a young unmarried HIV positive and Hepatitis-B positive patient who presented with non-healing genital ulcer lesions while on antiretroviral therapy and showed variable response and challenges to treatment with antivirals, steroids, antibacterials and change of ART and finally dramatic response with Thalidomide therapy which is rarely described in the literature.

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Section: Case Reportmentioning

confidence: 99%

Thalidomide: A Therapeutic Boon in the Management of Recurrent Genital Aphthous Ulceration in an Immunocompromised Individual

Madhubabu¹,

Padmaja²,

T³

et al. 2016

jemds

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“…Further reports of HIV-positive patients with oral ulceration treated successfully with thalidomide have been published [26,27] and a 4-week double-blind randomised placebo-controlled trial in 57 patients has confirmed its efficacy. [28] Beneficial effects of thalidomide have also been described in HIV-positive individuals with scrotal ulcers, [29,30] vulval ulcers, [31] oesophageal ulcers [32] and proctitis.…”

Section: Acquired Immunodeficiency Syndrome (Aids)mentioning

confidence: 99%

Thalidomide

Powell

1999

BioDrugs

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The major therapeutic effects of thalidomide are the selective inhibition of tumour necrosis factor-alpha production by monocytes and alteration in cellular surface expression of integrins. The major drawbacks of the drug are teratogenicity and irreversible axonal neuropathy. Despite the latter, the drug thalidomide has acquired a unique, albeit limited role, in the treatment of an array of clinical situations where standard therapies have failed. Its use in the treatment of erythema nodosum leprosum maintains its availability worldwide; however, its role in the treatment of graft versus host disease (GVHD) and in the treatment of severe oral and genital ulcers associated with HIV and Behçet's disease is more prominent in the developed world. The recent trials of thalidomide in rheumatoid arthritis emphasise the problems with tolerability; an unacceptably high rate of adverse events led to the premature termination of these studies. Guidelines to promote the safe use of thalidomide have been published. The use of regular monitoring of the amplitudes of sensory nerve action potentials before and during treatment is encouraged and the value of adequate contraception whilst on and immediately after taking thalidomide is stressed.

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“…Thalidomide was an effective treatment for aphthous ulcerations in at least 19 patients (Bernardo et al 1990;Connolly et al 1989;Georghiou & Kemp 1990;Gorin et al 1990;Radeff et al 1990;Williams et al 1991;Youle et al 1989). Daily doses 123 of 50 to 200mg were used during the acute phase and complete remission was achieved within 3 to 14 days.…”

Section: Use Of Thalidomide In Hiv Infectionmentioning

confidence: 99%

“…Daily doses 123 of 50 to 200mg were used during the acute phase and complete remission was achieved within 3 to 14 days. Recurrence of ulcers was not observed during maintenance therapy (50mg twice weekly or 100mg every 5 days) in 6 cases (Bernardo et al 1990;Radeff et al 1990;Y oule et al 1989). Recurrence of ulcers after complete discontinuation of thalidomide was not observed in 9 patients (Georghiou et al 1990;Gorin et al 1990;Williams et al 1991), and occurred only after several months in others (Youle et al 1989).…”

Section: Use Of Thalidomide In Hiv Infectionmentioning

confidence: 99%

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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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Recurrent aphthous ulcer in patient infected with human immunodeficiency virus: Successful treatment with thalidomide

Cited by 39 publications

References 10 publications

Thalidomide: A Therapeutic Boon in the Management of Recurrent Genital Aphthous Ulceration in an Immunocompromised Individual

Thalidomide: A Therapeutic Boon in the Management of Recurrent Genital Aphthous Ulceration in an Immunocompromised Individual

Thalidomide

Thalidomide in Human Immunodeficiency Virus (HIV) Patients

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