Thalidomide for the treatment of chronic gastrointestinal bleeding from angiodysplasias: a case series.

摘要: Background Mucosal angiodysplasias, either inherited or acquired, can cause gastrointestinal bleeding, sometimes refractory to treatment. From earlier case reports, thalidomide has been described possess some benefits in this disease, but its and risks nevertheless remain unclear. Objectives This pilot study assesses the efficacy, safety, side-effect of treatment patients with chronic bleeding from angiodysplasias. Methods Patients angiodysplasia requiring ongoing transfusion were eligible for open nonrandomized study. Thalidomide was started 50 mg/day then increased incrementally by mg every week up 200 mg/day, if tolerated, continued 6 months. Adverse events, hemoglobin, blood chemistry, monitored during 6-months posttreatment. Results Seven recruited Four discontinued within 3-8 weeks, because fatigue (two patients), peripheral neuropathy (one patient), skin rash patient). All side-effects resolved when discontinued. These four required same volume transfusions per month as pre-study. In contrast, three who 100-200 months did not require any medication. During posttreatment these patients, one maintained response without 2 months, 1 U 4 patient 3-4 died diabetes complications. Conclusion should be considered a therapeutic option are resistant conventional therapy, it high discontinuation rate side-effects.