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| |  DDW: Thalidomide Shows Promise in Controlling Gastrointestinal Bleeding and Lowering Vascular Endothelial Growth Factor By Larry Schuster SAN FRANCISCO, CA -- May 21, 2002 -- Thalidomide may be a valuable treatment option in patients with gastrointestinal (GI) bleeding of different origins, German researchers reported at Digestive Disease Week (DDW) here in San Francisco, California. Dr. Juergen Bauditz, Dr. Susanne Wedel, and Dr. Herbert Lochs, of Berlin, Germany, noted that thalidomide is an effective anti-inflammatory treatment for Crohn’s disease, and the drug’s antiangiogenic activity could make it useful for the treatment of severe GI bleeding. The study enrolled three patients with GI bleeding due to Crohn’s disease and three with GI bleeding of unknown origin. The patients had required a mean of 56 blood transfusions prior to the study.. Each received thalidomide 100mg/day to 300 mg/day, and serum levels of vascular endothelial growth factor (VEGF) were measured by enzyme-linked immunoabsorbent assay (ELISA). At week three of thalidomide treatment, none of the patients had bleeding recurrence. After a mean follow-up of 18 months, none had required transfusions. Two of the patients with Crohn’s disease experienced a recurrence of bleeding after discontinuing thalidomide; when treatment was restarted, the bleeding stopped within two weeks. In all three patients with Crohn’s disease, clinical activity decreased during treatment. A significant decrease in VEGF levels -- 541±141 before vs. 89±43 after treatment -- was found in all patients. Side effects were transient fatigue and, in one patient, peripheral neuropathy that developed after nine months and was reversed after dose reduction. The researchers recommend that further studies be conducted to evaluate thalidomide for control of severe intestinal bleeding.
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