Angiogenesis

, Volume 3, Issue 3, pp 201–204 | Cite as

Long-term remission of Crohn's disease treated with thalidomide: A seminal case report

  • Steven J. Fishman
  • Neil R. Feins
  • Robert J. D'Amato
  • Judah Folkman
Article

Abstract

A 31-year-old female with severe Crohn's disease for 15 years who had been treated with corticosteroids and 6-mercaptopurine, was treated with thalidomide initially for erythema nodosum. While on thalidomide all symptoms of Crohn's disease disappeared and she was able to discontinue all other drugs. At this writing she has been on thalidomide as sole therapy for over 4 years with the exception of a 5-week hiatus, during which time her symptoms recurred, but again disappeared after resumption of thalidomide therapy. This case suggests that thalidomide may be a useful therapy for Crohn's disease and provides impetus for a clinical trial of thalidomide for Crohn's disease.

angiogenesis angiogenesis inhibitor Crohn's disease thalidomide 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    McBride WG. Thalidomide and congenital abnormalities. [Letter] Lancet 1961; 2: 1358.CrossRefGoogle Scholar
  2. 2.
    Lenz W. Thalidomide and congenital abnormalities. Lancet 1962; i: 45.CrossRefGoogle Scholar
  3. 3.
    D'Amato RJ, Loughnan MS, Flynn E, Folkman J. Thalidomide is an angiogenesis inhibitor. Proc Natl Acad Sci USA 1994; 91: 4082–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Fine HA, Loeffler JS, Kyritsis A et al. A phase II trial of the anti-angiogenic agent, thalidomide in patients with recurrent high-grade gliomas. Proc Am Soc Clin Oncol 1997; 16 (Abstr #1372).Google Scholar
  5. 5.
    Singal S, Mehta J, Eddlemon P et al. Marked anti-tumor effect from anti-angiogenesis (AA) therapy with thalidomide (T) in high risk refractory multiple myeloma (MM). Blood 1998; 92: 318a (Abstr 1306, Suppl 1).Google Scholar
  6. 6.
    Jakeman P, Smith WLS. Thalidomide in leprosy reaction. Lancet 1994; 343: 432–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Hamuryundan V, Mat C, Saip S et al. Thalidomide in the treatment of the mucocutaneous lesions of the Behcet syndrome. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1998; 128: 443–50.Google Scholar
  8. 8.
    Lovell CR, Hawk JLM, Calnan CD, Magnus IA. Thalidomide in actinic prurigo. Br J Dermatol 1983; 108: 467–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Knop J, Bonsmann G, Happle R et al. Thalidomide in the treatment of sixty cases of chronic discoid lupus erythematosus. Br J Dermatol 1983; 108: 461–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Rovelli A, Arrigo C, Nesi F et al. The role of thalidomide in the treatment of refractory chronic graft-versus-host disease following bone marrow transplantation in children. Bone Marrow Transplant 1998; 21: 577–81.PubMedCrossRefGoogle Scholar
  11. 11.
    Heney D, Norfolk DR, Wheeldon J et al. Thalidomide treatment for chronic graft-versus-host disease. Br J Haematol 1991; 78: 23–7.PubMedGoogle Scholar
  12. 12.
    Silva SRB, Viana PCF, Lugon NV et al. Thalidomide for the treatment of uremic pruritus: A crossover randomized double-blind trial. Nephron 1994; 67: 270–3.PubMedCrossRefGoogle Scholar
  13. 13.
    Ryan J, Colman J, Pedersen J, Benson E. Thalidomide to treat esophageal ulcer in AIDS. N Engl J Med 1992; 327: 208–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Jacobson JM, Greenspan JS, Spritzler J et al. For the National Institute of Allergy and Infection Diseases AIDS Clinical Trial Group. Thalidomide for the treatment of oral aphthous ulcers in patients with human immunodeficiency viral infection. N Engl J Med 1997; 336: 1487–93.PubMedCrossRefGoogle Scholar
  15. 15.
    Waters MFR, Laing ABG, Ambikapathy A, Lennard-Jones JE. Treatment of ulcerative colitis with thalidomide. BMJ 1979; 1: 792.PubMedCrossRefGoogle Scholar
  16. 16.
    Larsson H. Case report. Treatment of severe colitis in Behcet's syndrome with thalidomide (CG-217). J Intern Med 1990; 228: 405–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Wettstein AR, Meagher AP. Thalidomide in Crohn's Disease [Letter]. Lancet 1997; 350: 1445–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Odeka EB, Miller V. Thalidomide in oral Crohn's disease refractory to conventional medical treatment [Letter]. J Pediatr Gastroenterol Nutr 1997; 25: 250–1.CrossRefGoogle Scholar
  19. 19.
    Folkan J, Brem H. Angiogenesis and inflammation. In: Gallin JL, Goldstein IM, Snyderman R (eds) Inflammation: Basic Principles and Clinical Correlates. Second edition. New York: Raven Press 1992; Chapter 40, 821–39.Google Scholar
  20. 20.
    Wakefield AJ, Dhillon AP, Rowles PM et al. Pathogenesis of Crohn's disease: Multifocal gastrointestinal infarction. Lancet 1989; 2: 1057–62.PubMedCrossRefGoogle Scholar
  21. 21.
    Bousvaros A, Zurakowski D, Fishman SJ et al. Serum basic fibroblast growth factor in pediatric Crohn's disease: Implications for wound healing. Dig Dis Sci 1997; 42: 3783–6.Google Scholar
  22. 22.
    Bousvaros A, Leichtner A, Zurakowski D et al. Elevated serum vascular endothelial growth factor in children and young adults with Crohn's disease. Dig Dis Sci 1999; 44: 424–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Taylor CT, Lisco SJ, Fishman SJ, Colgan SP. T84 intestinal epithelial cells express a functional VEGF receptor: Potential role in the regulation of ion transport. Gastroenterology 1997; 112: A1194.Google Scholar
  24. 24.
    Spalinger JH, Patriquin H, Miron M-C et al. Doppler sonography in Crohn's disease: Intestinal vessel density reflects disease activity. 1999; in press.Google Scholar
  25. 25.
    Sampaio EP, Sarno AN, Galilly R et al. Thalidomide selectively inhibits tumor necrosis factor a production by stimulated human monocytes. J Exp Med 1991; 173: 699–703.PubMedCrossRefGoogle Scholar
  26. 26.
    Murch SH, Lamkin VA, Savage MO et al. Serum concentrations of tumour necrosis factor-alpha in childhood chronic inflammatory bowel disease. Gut 1991; 32: 913–7.PubMedGoogle Scholar
  27. 27.
    Murch SH, Braegger CP, Walter-Smith JA, MacDonald TT. Location of tumour necrosis factor alpha by immunohistochemistry in chronic inflammatory bowel disease. Gut 1994; 34: 1705–9.Google Scholar
  28. 28.
    Crawford CL. Use of thalidomide in leprosy. Adverse Drug React Toxicol Rev 1994; 13: 177–92.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Steven J. Fishman
    • 1
  • Neil R. Feins
    • 4
  • Robert J. D'Amato
    • 3
  • Judah Folkman
    • 2
  1. 1.Department of SurgeryChildren's HospitalUSA
  2. 2.Department of SurgeryCell Biology, Harvard Medical SchoolUSA
  3. 3.Department of OphthalmologyHarvard Medical SchoolUSA
  4. 4.Department of Pediatric SurgeryThe Tufts New England Medical CenterBostonUSA

Personalised recommendations