Thalidomide Promising In Treatment-Resistant Ankylosing Spondylitis

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Thalidomide Promising In Treatment-Resistant Ankylosing Spondylitis

A DGReview of : " One-year open-label trial of thalidomide in ankylosing

spondylitis "

Arthritis Care and Research

07/30/2002

By Harvey McConnell

A long-term trial with thalidomide indicates it may be a promising compound

for use in patients with treatment-resistant ankylosing spondylitis.

In a joint Chinese-American study, researchers had two aims: to find if

thalidomide could be efficacious in the treatment of ankylosing spondylitis

and whether it would produce changes in expression of genes in peripheral

blood mononuclear cells (PBMC). The open label study was led by Dr Tak

Yan Yu, Rheumatology Division, University o of California, Los Angeles,

United States, and colleagues in China.

Thirty men who had treatment-refractory ankylosing spondylitis were

recruited into the 12-month open study. Thalidomide was given at a dosage of

200 mg/day.

Clinicians used seven measurements of primary endpoint indices, as well as

six other indices for assessing secondary endpoints Before the trial

started, transcripts in the PBMC of some of these patients were screened by

assay, and then it was measured with reverse transcriptase-polymerase chain

reaction.

Overall, 26 of the patients completed the 12 month trial, and clinicians

found that 80 percent showed a more than 20 percent improvement in four of

the seven primary outcome indices. There were sharp declines among some of

the indices between the third and sixth month.

Nine patients became free of pain. There also was a statistically

significant decrease in tumour necrosis factor transcripts in the PBMC.

Arthritis Care & Research Volume 47, Issue 3, 2002. Pages: 249-254.