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

Abstract : 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. 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. 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 The proportions of patients from whom thalidomide was withdrawn because of lack/loss of efficacy and/or toxicity were 35% at 3 months of treatment, 69% at 12 months, and 88% at 24 months. The proportions of patients from whom thalidomide was withdrawn because of toxicity alone were 22% at 3 months, 34% at 12 months, and 46% at 24 months.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. 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.
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Submitted on : Tuesday, April 5, 2016 - 4:34:12 PM
Last modification on : Tuesday, February 26, 2019 - 10:12:46 AM

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Marion Simon, Benjamin Pariente, Jérôme Lambert, Jacques Cosnes, Yoram Bouhnik, et al.. Long-term Outcomes of Thalidomide Therapy for Adults With Refractory Crohn's Disease.. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015, 14 (7), pp.966-972.e2. ⟨10.1016/j.cgh.2015.10.034⟩. ⟨hal-01298245⟩

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