Thalidomide: An experience in therapeutic outcome and adverse reactions

Abstract

Thalidomide appears promising in a number of inflammatory dermatological conditions and will probably find new usages in future. The treating physicians need to be wary of the thrombo-embolic complications due to thalidomide especially when glucocorticoids or other chemotherapeutic agents such as doxorubicin, gemcitabine, 5-fluorouracil or dexamethasone-cyclophosphamide pulse therapy are being used concomitantly, and in patients of metastatic renal carcinoma, myelodysplastic syndrome or multiple myeloma receiving thalidomide/chemotherapy. Antiphospholipid or anticardiolipin antibodies appear to be other possible risk factors for this complication.

Thalidomide in 42 Patients with Prurigo Nodularis Hyde

“…Among the more frequent side effects are sedation, constipation, rash and dizziness. Less frequent adverse effects include edema, dryness, pruritus, neutropenia, bradycardia, tachycardia, hypotension, headache, mood changes, nausea, increased appetite, weight gain, male sexual dysfunction, amenorrhea, ovarian failure and thrombosis [1,3,4,5]. In addition, thalidomide can result in hypothyroidism [6].…”

“…Thalidomide is approved by the US FDA in the treatment of chronic recurrent/severe erythema nodosum leprosum and in Europe by EMEA in the treatment of multiple myeloma in combination with melphalan and prednisone in patients who have not been treated for multiple myeloma before. Thalidomide is also used for a large variety of both dermatologic and nondermatologic conditions [1,3]. Besides the notorious teratogenicity, thalidomide has numerous well-known side effects.…”

Lepromatous Leprosy Mimicking Systemic Lupus Erythematosus

“…This medication is a paradox for rheumatologists because it can induce thrombosis [22], a special concern for aPL-positive patients. It is not clear from the few case reports that if thalidomide induces thrombosis through aPL production or other mechanisms.…”

Thalidomide-Associated Thrombosis in the Treatment of HIV-Associated Severe Aphthous Disease

“…Comparatively, the rate of thrombosis in the general population is estimated at 1%. 5,6 Single-agent thalidomide therapy in patients with MM has not been found to increase the incidence of thrombotic events. It is the concurrent use of corticosteroids or chemotherapy with thalidomide that appears to significantly increase a patient's risk of thrombosis.…”

“…Recently, there has been a revival of interest in using this drug to treat multiple myeloma (MM), various other malignancies, and inflammatory dermatologic conditions, including inflammatory forms of Hansen's disease. [4][5][6] As experience with this drug has grown, thromboembolic events have emerged as a significant side effect. The incidence of thrombosis is 3% to 58% among the patients with MM taking thalidomide and 20% among patients with inflammatory dermatoses receiving thalidomide.…”