title: [Japanese guideline on thalidomide usage in the management of erythema nodosum leprosum].
abstract: Treatment of erythema nodosum leprosum (ENL, type 2 reaction) using thalidomide provides effective alternative choice to steroid therapy. Yet, the Japanese National Health Insurance approves thalidomide prescription only for the treatment of multiple myeloma under the Thalidomide Education and Risk Management System (TERMS). Benefit of thalidomide therapy for patients with ENL is already an established fact based on various reports from other countries, but limited experiences and standards in Japan have hindered application of the medication to our patients. This led us to compose a local guideline. Based on and following the TERMS, we suggest starting thalidomide from 50-100 mg/day and then onwards adjusting the dose according to the symptoms of each patient, not to exceed the maximum recommended dose of 300 mg/day, for the treatment of ENL.
authors.affiliation: Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan. norishii@nih.go.jp
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishii
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ishida
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Okano
authors.forename: Motoaki
authors.initials: M
authors.lastname: Ozaki
authors.forename: Masaich
authors.initials: M
authors.lastname: Gidoh
authors.forename: Kimiko
authors.initials: K
authors.lastname: Kumano
authors.forename: Masamichi
authors.initials: M
authors.lastname: Goto
authors.forename: Reiko
authors.initials: R
authors.lastname: Nogami
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hatano
authors.forename: Akatsuki
authors.initials: A
authors.lastname: Yamada
authors.forename: Rie Roselyne
authors.initials: RR
authors.lastname: Yotsu
mesh_terms: D004893:Erythema Nodosum / Q000188:drug therapy*; D006801:Humans; D007564:Japan; D007917:Leprostatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015440:Leprosy, Lepromatous / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D012308:Risk Management; D013792:Thalidomide / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D007917:Leprostatic Agents; D013792:Thalidomide