Thalidomide Effective, Safe in GI Vascular Malformations

No severe adverse effects, minor side effects common with thalidomide treatment

FRIDAY, Oct. 28 (HealthDay News) -- For patients with refractory bleeding from gastrointestinal vascular malformations, treatment with thalidomide is effective, according to a study published in the November issue of Gastroenterology.

Zhi-Zheng Ge, M.D., Ph.D., from the Shanghai Jiao-Tong University School of Medicine Renji Hospital in China, and colleagues investigated the long-term efficacy and safety of thalidomide for refractory bleeding from gastrointestinal vascular malformations. A total of 27 patients and 28 controls were randomly allocated to receive either 100 mg thalidomide or 400 mg iron daily for four months and were followed up for at least one year. The effective response rate, defined as the proportion of patients with a 50 percent or greater decrease in bleeding episodes in the first year of the follow-up period was the primary outcome. Rates of cessation of bleeding, blood transfusion, overall hospitalization, and hospitalization for bleeding were the secondary end points. In the thalidomide group, plasma levels of vascular endothelial growth factor were measured.

The investigators found that there was a significant difference in the rates of response in the thalidomide and control groups (71.4 and 3.7 percent, respectively). There were significant differences between the two groups for all secondary end points, with thalidomide more effective. There were no severe adverse effects, but in the thalidomide group, minor side effects were common. Thalidomide significantly reduced levels of vascular endothelial growth factor.

"Thalidomide is effective and relatively safe for refractory bleeding from gastrointestinal vascular malformations," the authors write.

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