title: Systematic review: thalidomide and thalidomide analogues for treatment of inflammatory bowel disease.
abstract: BACKGROUND
  It has been reported that thalidomide may be effective in treating inflammatory bowel disease (IBD).
  
  
  OBJECTIVE
  To review the evidence examining the efficacy and safety of thalidomide for inducing and maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC).
  
  
  METHODS
  The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed (1950-August 2014), EMBASE (1984-August 2014), Scopus, and Web of knowledge were searched for randomised controlled trials (RCTs), observational studies and case series. The primary outcomes were induction of remission or response for active IBD or relapse rate for patients in remission and subsequently on thalidomide/analogues for at least 3 months.
  
  
  RESULTS
  Twelve studies (2 RCTs and 10 case series) met the inclusion criteria for inducing remission and included 248 patients (10 with UC, 238 with CD). Only one RCT of paediatric CD achieved high quality scores (remission rate thalidomide: 46%, placebo: 12%; p=0.01). The crude pooled remission rate for thalidomide was 49% and 25% in luminal and perianal CD respectively. For UC, 50% achieved remission and 10% had partial response. One case series reported 21 patients (17 CD, four UC) who maintained remission for 6 months. Many adverse events were reported including sedation (32%) and peripheral neuropathy (20%).
  
  
  CONCLUSIONS
  One high quality RCT showed that thalidomide is effective for inducing remission in paediatric CD. The current evidence is insufficient to support using thalidomide to induce remission in UC or adult CD, or to maintain remission in IBD. Significant adverse events may occur, necessitating discontinuation of thalidomide.
authors: Department of Pediatrics, Faculty of Health Sciences, College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
authors: C
authors: C
authors: Yang
authors: P
authors: P
authors: Singh
authors: H
authors: H
authors: Singh
authors: M-L
authors: ML
authors: Le
authors: W
authors: W
authors: El-Matary
mesh_terms: D000328:Adult; D002648:Child; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy; D012074:Remission Induction; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use*
chemical_list: D013792:Thalidomide