Disappearance of Crohn’s ulcers in the terminal ileum after thalidomide therapy: Summary

In: Crohn's disease

21 Aug 2012

colonoscopy

In June 1999 he came in for another colonoscopy. There was marked improvement of the appearance of the terminal ileum, with only a few small ulcers remaining (Figure 3). It was decided at that time to continue the thalidomide for another three months and this was carried out. In late 1999 he felt well with no further symptoms and returned to work for the first time in three years. A telephone conversation with his family practitioner in Cranbrook, British Columbia confirmed that up until January of 2003 the patient had been asymptomatic, off all medications, had gained 20 kg in weight and had returned to work. His hemoglobin remained stable.

Colonoscopic demonstration of the virtual disappearance of ileal ulcers

Figure 3) Colonoscopic demonstration of the virtual disappearance of ileal ulcers, June 1999

A patient with intractable Crohn’s ulcers in the terminal ileum achieved a complete remission after a short course of thalidomide. At the present time, he is asymptomatic and is not using any medication.

Thalidomide was supplied by the Celgene Corporation on a compassionate basis.

Since the original publication by Wettstein and Meagher , there have been two large open-label studies of this drug in chronically active steroid-dependent Crohn’s disease patients. Vasiliauskis et al reported excellent results with low dose thalidomide (50 mg/day to 100 mg/day).


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