Thalidomide for improving cutaneous and pulmonary sarcoidosis in patients resistant or with contraindications to corticosteroids

Fazzi, P; Manni, Elisabetta; Cristofani, Renza; Cei, G; Piazza, Selina; Calabrese, R; Antonelli, Alessandro; Siciliano, Gabriele; Barachini, Paolo; Carpi, Angelo

doi:10.1016/j.biopha.2012.03.005

Cited by 36 publications

(13 citation statements)

References 39 publications

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“…178 Despite this disappointing outcome, it is possible that more prolonged and/or higher doses of thalidomide may achieve better results, particularly since a non-controlled study with less precise methodology found that the percentage of complete responses induced by thalidomide in the subjects with cutaneous sarcoidosis rose from 32% at 3 months to 67% at 6 months, respectively. 160 Notably, in the open-label follow up trial conducted at the conclusion of the prospective 3 month Droitcourt study, 11 of 14 patients who remained on thalidomide for 6 months as well as 10 of 14 receiving placebo improved or very well improved, suggesting the possible benefit of time. Besides concern about teratogenicity and neuropathy, major drawbacks are the need to enroll in a restricted program under the Thalidomide Risk Evaluation and Mitigation Strategy program and reluctance for insurance to cover because the drug does not have regulatory approval for sarcoidosis.…”

Section: Tumor Necrosis Factor Alpha Inhibitorsmentioning

confidence: 96%

“…[157][158][159][160]177 Often, responders relapse after thalidomide discontinuation. 159,160 A more recently published, multicenter, randomized, double-blind, placebo-controlled investigatormasked study that included an intent-to-treat population of 39 subjects with clinical and biopsy confirmed cutaneous sarcoidosis did not achieve complete responses after 3 months of thalidomide at a dose of 100 mg daily and, similarly to the control group, 21% had partial responses.…”

Section: Tumor Necrosis Factor Alpha Inhibitorsmentioning

confidence: 99%

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Sarcoidosis

Sanchez

Haimovic

Prystowsky

2015

Dermatologic Clinics

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Sarcoidosis is a disease characterized by noncaseating granulomatous infiltration of 1 or more organs. In North America, after the lungs and thoracic lymph nodes, the skin is the next most commonly involved organ. Data from multiple studies indicate a coaction between genetic and environmental factors in immunologically susceptible hosts. The disease's many clinical manifestations and course vary greatly and are influenced by race, ethnicity, and gender. In the skin, the lesions of sarcoidosis are classified as specific when noncaseating granulomas are present, and nonspecific when there is an inflammatory reaction pattern devoid of granulomas.

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Section: Tumor Necrosis Factor Alpha Inhibitorsmentioning

confidence: 96%

Section: Tumor Necrosis Factor Alpha Inhibitorsmentioning

confidence: 99%

Sarcoidosis

Sanchez

Haimovic

Prystowsky

2015

Dermatologic Clinics

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“…[160][161][162][163][164] Because of its side effect profile, including teratogenicity, neuropathy, and venous thrombosis, it often is reserved for recalcitrant or severe skin disease. A recent double-blind placebo-controlled trial failed to show efficacy in patients with severe cutaneous disease.…”

Section: Differential Diagnosismentioning

confidence: 99%

Cutaneous Sarcoidosis

Wanat

Rosenbach

2015

Clinics in Chest Medicine

109

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The skin is the second most common organ affected in sarcoidosis, which can affect patients of all ages and races, with African American women having the highest rates of sarcoidosis in the United States. The cutaneous manifestations are protean and can reflect involvement of sarcoidal granulomas within the lesion or represent reactive non-specific inflammation, as seen with erythema nodosum. Systemic work-up is necessary in any patient with cutaneous involvement of sarcoidal granulomas, and treatment depends on other organ involvement and severity of clinical disease. Skin-directed therapies are first line for mild disease, and immunomodulators or immunosuppressants may be necessary.

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“…This response was attributed to macrophage inhibition. No benefit attributed in treatment of Pulmonary Sarcoidosis [13].…”

Section: Sarcoidosismentioning

confidence: 99%

Forgive sins: rise of thalidomide

Inakanti¹,

Kumar²

2014

Our Dermatol Online

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Thalidomide was originally used as a Wonder Drug to treat morning sickness and insomnia in pregnant women in late 1950s. It became apparent in early 1960s that thalidomide treatment resulted in severe birth defects in thousands of children. Then it was banned in most of countries. Later on discovered anti-inflammatory and anti-angiogenic properties of Thalidomide proved to be useful for treatment of leprosy and multiple myeloma. A series of immunomodulatory drugs created by chemical modification of thalidomide have been developed to overcome the original devastating side effects. It's being investigated extensively as a treatment for many other severe cutaneous disorders and advanced cancers. We briefly review pharmacological and the therapeutic profile of thalidomide.

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Thalidomide for improving cutaneous and pulmonary sarcoidosis in patients resistant or with contraindications to corticosteroids

Cited by 36 publications

References 39 publications

Sarcoidosis

Sarcoidosis

Cutaneous Sarcoidosis

Forgive sins: rise of thalidomide

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