DGI-031 Efficacy of Oral Thalidomide in Patients with Recurrent Gastrointestinal Bleeding

Background

Recurrent gastrointestinal bleeding caused by angiodysplasia, and not responding to standard treatment, currently lacks effective medical treatment.

Purpose

To evaluate the efficacy of oral thalidomide in patients with gastrointestinal bleeding from angiodysplasia refractory to other treatments.

Materials and Methods

Retrospective study for a year including all patients with recurrent gastrointestinal bleeding treated with oral thalidomide manufactured in the pharmacotechnic unit of a tertiary level hospital. The information was obtained from the outpatient dispensing programme Farmatools, the Paracelso pharmacotechnics programme, and by reviewing medical records from the hospital 1, Archinet. For each patient we extracted the diagnosis, treatments used for gastrointestinal bleeding, line and duration of treatment with thalidomide and transfusion requirements after treatment.

Results

In the study period were identified 3 patients for whom the Digestive Service ordered thalidomide capsules 100 mg. The patients had not responded to standard treatments such as argon gas sessions and octreotide. They were introduced to thalidomide 100 mg daily for 4 months. One of them discontinued treatment for intolerance and the other 2 completed the course. There was a decrease in the number of transfusions after treatment with thalidomide in all 3 cases.

Conclusions

Thalidomide appears to be a therapeutic alternative to consider when treating gastrointestinal bleeding caused by angiodysplasia in cases where there is no response to conventional treatments. One impediment to this treatment option is intolerance in some patients, leading to treatment discontinuation. Thalidomide is less aggressive than other drugs used and appears to decrease patients’ transfusion requirements. No conflict of interest.