Long-term Outcomes of Thalidomide Therapy for Adults With Refractory Crohn's Disease

作者：Simon Marion^*; Pariente Benjamin; Lambert Jerome; Cosnes Jacques; Bouhnik Yoram; Marteau Philippe; Allez Matthieu; Colombel Jean Frederic; Gornet Jean Marc

来源：Clinical Gastroenterology and Hepatology, 2016, 14(7): 966-+.

DOI：10.1016/j.cgh.2015.10.034

• IBD
• Drug
• Side Effect
• Immune Suppression

BACKGROUND & AIMS: Little is known about the efficacy and safety of thalidomide therapy for patients with refractory Crohn's disease (CD), particularly in respect to long-term outcomes of patients.
METHODS: We conducted a retrospective multicenter observational study to evaluate thalidomide efficacy and the probability of its withdrawal because of either toxicity or lack/loss of efficacy. We analyzed data from 77 patients with active intestinal and/or perineal CD, refractory to conventional immunosuppressive therapies, treated with thalidomide at 5 tertiary referral inflammatory bowel disease centers in France. We also analyzed the long-term efficacy of thalidomide.
RESULTS: Fifty-four percent of the patients were in clinical remission after thalidomide treatment within the first year. The proportions of patients from whom thalidomide was withdrawn because of lack/loss of efficacy and/or toxicity were 35% at 3 months of treatment, 69% at 12 months, and 88% at 24 months. The proportions of patients from whom thalidomide was withdrawn because of toxicity alone were 22% at 3 months, 34% at 12 months, and 46% at 24 months. Overall, neuropathy occurred in 30 patients and was the main reason for thalidomide withdrawal.
CONCLUSIONS: On the basis of a retrospective multicenter observational study, thalidomide therapy is effective in most patients with refractory active intestinal and/or perineal CD. However, its toxicity limits its use as a maintenance therapy.

• 出版日期2016-7