News - Thalidomide OK for Severe Childhood Arthritis

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Thalidomide OK for Severe Childhood Arthritis

Fri Dec 17, 3:14 PM ET

NEW YORK (Reuters Health) - Thalidomide, the drug that caused a spate of

birth defects back in the 60s, may redeem itself as a treatment for children

with a severe form of arthritis -- called systemic onset juvenile rheumatoid

arthritis, or SoJRA -- according to a new study.

" Children with SoJRA often have a poor outcome because of chronic

inflammation and corticosteroid side effects, " Dr. J. A. Lehman, of

the Hospital for Special Surgery, in New York, and colleagues write in the

Journal of Pediatrics.

" Thalidomide is a unique anti-inflammatory agent, " they explain, that

suppresses several inflammatory factors.

The team studied 13 children who had not responded to conventional therapy

and were given thalidomide and followed for 6 months. Eleven of the patients

had a sustained response to the drug with adequate disease control.

Improvement was observed within 4 weeks in most patients.

On average, the children were able to reduce their dose of steroids by about

two-thirds over the 6-month period, and six of them were able to discontinue

prednisone.

The team saw a decrease in the average number of affected joints -- from 19

to 6 -- and none of the patients had an increase in their affected joint

count.

Only minor side effects were reported. Numbness and tingling were common at

the start of treatment, but all the participants were able to continue on

treatment at the same or a decreased dosage.

" The risks of the low dosage of thalidomide used in this study are

acceptable " when compared with the permanent physical and psychological

consequences of prolonged high-dose steroid therapy, Lehman's group says.

" Further, " they add, " the possible toxicities of thalidomide are small when

compared with those of autologous stem cell transplantation and other

proposed salvage therapies for severe SoJRA. "

SOURCE: Journal of Pediatrics, December 2004.