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Review
Emerging role of thalidomide in the treatment of gastrointestinal bleeding
  1. Michael McFarlane,
  2. Lauren O’Flynn,
  3. Rachel Ventre,
  4. Benjamin R Disney
  1. Department of Gastroenterology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  1. Correspondence to Dr Benjamin R Disney, Department of Gastroenterology, University Hospitals Coventry and Warwickshire NHS Trust, CV2 2DX Coventry, UK; ben.disney{at}uhcw.nhs.uk

Abstract

Thalidomide was initially synthesised in 1954 and marketed as a sedative and antiemetic for morning sickness. It was withdrawn in 1961 due to the realisation that it was teratogenic with over 10 000 children born with congenital abnormalities. Since then it has been used for treatment of dermatological and oncological conditions, including myeloma. In 1994, it was found to have a potent antiangiogenic effect via downregulation of vascular endothelial growth factor (VEGF). This has led to its use in gastrointestinal bleeding, as vascular abnormalities such as angiodysplasia have been found to have elevated VEGF levels. This article will review the current evidence of the use of thalidomide in bleeding associated with gastrointestinal vascular malformations, including angiodysplasia, gastric cancer and radiation-induced proctitis.

  • thalidomide
  • gastrointestinal bleeding

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Footnotes

  • Contributors MM: manuscript writing and editing. LO’F, RV: manuscript writing. BRD: manuscript editing and project guarantor.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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