Document Detail


A prospective trial of thalidomide for the treatment of HIV-associated idiopathic esophageal ulcers.
MedLine Citation:
PMID:  9071429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thalidomide appears to be highly effective for oropharyngeal apthous ulcers in HIV-infected patients. However, there are limited data regarding the use of this drug for the treatment of HIV-associated idiopathic esophageal ulcer(s) (IEU). Twelve HIV-infected patients with esophageal symptoms and IEU as defined by previously proposed criteria were studied prospectively. Two of these patients had failed oral corticosteroid treatment, and two others had a previous history of IEU. Patients were treated with thalidomide (200 mg/day orally) for 28 days in an open label fashion. Clinical evaluation was performed weekly with endoscopic reexamination performed at the completion of treatment. After therapy, patients were followed clinically with endoscopy recommended for recurrent esophageal symptoms. Of the 12 treated patients, 11 (92%) had a complete symptomatic response; endoscopy in 11 patients at the completion of treatment showed 9 with complete ulcer healing, 1 partially healed, and 1 with no response. All responders were asymptomatic by day 28. The partial responder received an additional 1 month of thalidomide at 300 mg/day, resulting in complete endoscopic healing. The patient failing therapy received prednisone, but died prior to completing this therapy. On follow-up to 20 months, six patients have died with no recurrence of IEU. Three patients had relapse of IEU, two of whom had a prior history of multiple recurrences of IEU; both of these patients relapsed within 2 months of completing thalidomide treatment. The drug was well tolerated without significant side effects. Thalidomide appears to be an effective and well-tolerated alternative to prednisone for the treatment of IEU.
Authors:
L N Alexander; C M Wilcox
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  AIDS research and human retroviruses     Volume:  13     ISSN:  0889-2229     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-07-15     Completed Date:  1997-07-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  301-4     Citation Subset:  IM; X    
Affiliation:
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Ulcer Agents / therapeutic use*
Esophageal Diseases / drug therapy*
Follow-Up Studies
HIV Infections / complications*
Humans
Prospective Studies
Thalidomide / therapeutic use*
Ulcer / drug therapy*
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents; 50-35-1/Thalidomide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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