Thalidomide for refractory gastrointestinal bleeding from vascular malformations in patients with significant comorbidities
Alexis Bayudan, Chien-Huan Chen
Abstract
BACKGROUND: Refractory gastrointestinal bleeding (GIB) secondary to gastrointestinal vascular malformations (GIVM) such as gastrointestinal angiodysplasia (GIAD) and gastric antral vascular ectasia (GAVE) remains challenging to treat when endoscopic therapy fails. Recently thalidomide has been suggested as a treatment option for refractory GIB. AIM: To determine the outcome of patients treated with thalidomide for refractory GIB due to GIVM. METHODS: IRB approved, single center, retrospective review of electronic medical records from January 2012 to November 2018. Patients age > 18 years old, who had > 3 episodes of GIB refractory to medical or endoscopic therapy, and who had been treated with thalidomide for at least 3 mo were included. The primary endpoint was recurrence of GIB 6 mo after initiation of thalidomide. RESULTS: = 2). CONCLUSION: Thalidomide appears to be an effective treatment for refractory GIB due to GIAD or GAVE in a Western population with significant comorbidities.