Anthony K Akobeng1, Pieter C Stokkers. 1. Department of Paediatric Gastroenterology, Central Manchester and Manchester Children's University Hospitals, Booth Hall Children's Hospital, Charlestown Road, Blackley, Manchester, UK, M9 7AA. akobeng@aol.com
Abstract
BACKGROUND: Maintenance of remission is a major issue in the management of Crohn's disease. Thalidomide, a tumour necrosis factor-alpha (TNF-alpha) inhibitor and its analogue, lenalidomide, may have a role in the management of Crohn's disease, but it is not clear whether it is an effective maintenance therapy. OBJECTIVES: To conduct a systematic review to evaluate the efficacy and safety of thalidomide and lenalidomide for the maintenance of remission in Crohn's disease. SEARCH STRATEGY: MEDLINE (1966 to September 2008), EMBASE (1984 to September 2008), the Cochrane Central Register of Controlled Trials from the Cochrane Library (Issue 3, 2008) and the IBD/FBD Review Group Specialized Trials Register were searched to identify relevant studies. SELECTION CRITERIA: Randomised controlled trials which compared thalidomide with either placebo or an active comparator were considered for inclusion. DATA COLLECTION AND ANALYSIS: No trials met the inclusion criteria. MAIN RESULTS: No studies that satisfied the inclusion criteria were found. In the absence of any suitable randomised controlled trial in this area, no analysis was performed. AUTHORS' CONCLUSIONS: There is no evidence to support or refute the use of thalidomide or its analogue, lenalidomide, as maintenance therapy for patients with Crohn's disease. Given the teratogenic nature of thalidomide its use for maintenance therapy is difficult to justify. Well designed clinical trials are needed to evaluate the efficacy and safety of lenalidomide in Crohn's disease and its use is not recommended until these data are available.
BACKGROUND: Maintenance of remission is a major issue in the management of Crohn's disease. Thalidomide, a tumour necrosis factor-alpha (TNF-alpha) inhibitor and its analogue, lenalidomide, may have a role in the management of Crohn's disease, but it is not clear whether it is an effective maintenance therapy. OBJECTIVES: To conduct a systematic review to evaluate the efficacy and safety of thalidomide and lenalidomide for the maintenance of remission in Crohn's disease. SEARCH STRATEGY: MEDLINE (1966 to September 2008), EMBASE (1984 to September 2008), the Cochrane Central Register of Controlled Trials from the Cochrane Library (Issue 3, 2008) and the IBD/FBD Review Group Specialized Trials Register were searched to identify relevant studies. SELECTION CRITERIA: Randomised controlled trials which compared thalidomide with either placebo or an active comparator were considered for inclusion. DATA COLLECTION AND ANALYSIS: No trials met the inclusion criteria. MAIN RESULTS: No studies that satisfied the inclusion criteria were found. In the absence of any suitable randomised controlled trial in this area, no analysis was performed. AUTHORS' CONCLUSIONS: There is no evidence to support or refute the use of thalidomide or its analogue, lenalidomide, as maintenance therapy for patients with Crohn's disease. Given the teratogenic nature of thalidomide its use for maintenance therapy is difficult to justify. Well designed clinical trials are needed to evaluate the efficacy and safety of lenalidomide in Crohn's disease and its use is not recommended until these data are available.
Authors: E A Vasiliauskas; L Y Kam; M T Abreu-Martin; P V Hassard; K A Papadakis; H Yang; J B Zeldis; S R Targan Journal: Gastroenterology Date: 1999-12 Impact factor: 22.682
Authors: Stephen B Hanauer; Brian G Feagan; Gary R Lichtenstein; Lloyd F Mayer; S Schreiber; Jean Frederic Colombel; Daniel Rachmilewitz; Douglas C Wolf; Allan Olson; Weihang Bao; Paul Rutgeerts Journal: Lancet Date: 2002-05-04 Impact factor: 79.321
Authors: W J Sandborn; S B Hanauer; P Rutgeerts; R N Fedorak; M Lukas; D G MacIntosh; R Panaccione; D Wolf; J D Kent; B Bittle; J Li; P F Pollack Journal: Gut Date: 2007-02-13 Impact factor: 23.059
Authors: Carolyn Bariol; Alan P Meagher; Christopher R Vickers; David J Byrnes; Paul D Edwards; Michael Hing; Antony R Wettstein; Andrew Field Journal: J Gastroenterol Hepatol Date: 2002-02 Impact factor: 4.029
Authors: Bruce E Sands; Frank H Anderson; Charles N Bernstein; William Y Chey; Brian G Feagan; Richard N Fedorak; Michael A Kamm; Joshua R Korzenik; Bret A Lashner; Jane E Onken; Daniel Rachmilewitz; Paul Rutgeerts; Gary Wild; Douglas C Wolf; Paul A Marsters; Suzanne B Travers; Marion A Blank; Sander J van Deventer Journal: N Engl J Med Date: 2004-02-26 Impact factor: 91.245
Authors: Stefano Palomba; Giuliana Sereni; Angela Falbo; Marina Beltrami; Silvia Lombardini; Maria Chiara Boni; Giovanni Fornaciari; Romano Sassatelli; Giovanni Battista La Sala Journal: World J Gastroenterol Date: 2014-06-21 Impact factor: 5.742