title: Long-term Outcomes of Thalidomide Therapy for Adults With Refractory Crohn's Disease.
abstract: Little is known about the efficacy and safety of thalidomide therapy for patients with refractory Crohn's disease (CD), particularly in respect to long-term outcomes of patients.
  
  
  
  We conducted a retrospective multicenter observational study to evaluate thalidomide efficacy and the probability of its withdrawal because of either toxicity or lack/loss of efficacy. We analyzed data from 77 patients with active intestinal and/or perineal CD, refractory to conventional immunosuppressive therapies, treated with thalidomide at 5 tertiary referral inflammatory bowel disease centers in France. We also analyzed the long-term efficacy of thalidomide.
  
  
  
  Fifty-four percent of the patients were in clinical remission after thalidomide treatment within the first year. The proportions of patients from whom thalidomide was withdrawn because of lack/loss of efficacy and/or toxicity were 35% at 3 months of treatment, 69% at 12 months, and 88% at 24 months. The proportions of patients from whom thalidomide was withdrawn because of toxicity alone were 22% at 3 months, 34% at 12 months, and 46% at 24 months. Overall, neuropathy occurred in 30 patients and was the main reason for thalidomide withdrawal.
  
  
  
  On the basis of a retrospective multicenter observational study, thalidomide therapy is effective in most patients with refractory active intestinal and/or perineal CD. However, its toxicity limits its use as a maintenance therapy.
authors.affiliation: Department of Gastroenterology, Institut Mutualiste Montsouris, Paris, France; Department of Gastroenterology, St-Louis Hospital, AP-HP Paris, France. Electronic address: marion.simon3@free.fr.
authors.forename: Marion
authors.initials: M
authors.lastname: Simon
authors.affiliation: Department of Gastroenterology, Huriez Hospital, Université Lille 2, Lille, France; Inserm Unit 995, Université Lille 2, Lille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pariente
authors.affiliation: Department of Biostatistics, Saint-Louis Hospital, AP-HP Paris, France; ECSTRA (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 Inserm, Université Paris Diderot, Sorbonne Paris Cité, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Lambert
authors.affiliation: Department of Gastroenterology, St-Antoine Hospital, AP-HP Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cosnes
authors.affiliation: Department of Gastroenterology, Beaujon Hospital, AP-HP Clichy, France.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
authors.affiliation: Department of Gastroenterology, Lariboisière Hospital, AP-HP Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Marteau
authors.affiliation: Department of Gastroenterology, St-Louis Hospital, AP-HP Paris, France; Inserm Unit Avenir U940, St-Louis Hospital, AP-HP Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Allez
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Colombel
authors.affiliation: Department of Gastroenterology, St-Louis Hospital, AP-HP Paris, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Gornet
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005602:France; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use*; D013995:Time; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D013792:Thalidomide
keywords: Drug; IBD; Immune Suppression; Side Effect