Objective
Thalidomide is an effective systemic agent in the management of ulcerative oromucosal
conditions. However, its clinical use is limited because of its known adverse effect
profile, including teratogenicity, peripheral neuropathy, and thromboembolic risk.
The aim of this study was to review the efficacy and safety of thalidomide over a
10-year period in an Oral Medicine specialty clinic.
Study Design
Clinical records of the Oral Medicine Department at the Royal National ENT and Eastman
Dental Hospitals (London, UK) were retrospectively reviewed for patients prescribed
thalidomide between 2009 and 2019 for the management of oromucosal ulceration. Twelve
eligible patients were identified. Data on patient response to treatment and major/minor
adverse events were obtained from their clinical and electrophysiologic records.
Results
A complete remission rate was noted in 50% (6 of 12) patients treated for recurrent
aphthous stomatitis, HIV-related ulceration and oral Crohn disease. A thalidomide-induced
neuropathy rate of 41.7% (5 of 12) was detected by electrophysiology testing, however
clinical symptoms of neuropathy were only described by 3 subjects. No other major
adverse effects were reported.
Conclusions
Thalidomide demonstrates a good efficacy-to-safety ratio in the management of oromucosal
ulceration over a prolonged treatment period. Interval electrophysiologic testing
is essential to monitor for thalidomide-induced neuropathy. In this cohort, neuropathy
does not appear to be a dose-dependent outcome.
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Article info
Publication history
Published online: July 01, 2020
Accepted:
June 4,
2020
Received in revised form:
May 13,
2020
Received:
March 25,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
