{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:55:08Z","timestamp":1788188108546,"version":"build-2803163510"},"reference-count":79,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,1,16]],"date-time":"2012-01-16T00:00:00Z","timestamp":1326672000000},"content-version":"vor","delay-in-days":3212,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2003,4]]},"abstract":"<jats:p>Thalidomide, administered as a sedative and antiemetic decades ago, was considered responsible for numerous devastating cases of birth defects and consequently was banned from markets worldwide. However, the drug remarkably has resurfaced with promise of immunomodulatory benefit in a wide array of immunologic disorders for which available treatments were limited. It is approved by the Food and Drug Administration for erythema nodosum leprosum (ENL). Although the relative paucity of leprosy and ENL worldwide may perceivably limit interest in and knowledge about thalidomide, increasing numbers of new and potential uses expand its applicability widely beyond ENL. Thalidomide, an inhibitor of tumor necrosis factor a, is the best known agent for short\u2010term treatment of ENL skin manifestations, as well as postremission maintenance therapy to prevent recurrence. For this indication, it is effective as monotherapy and as part of combination therapy with corticosteroids. Studies of thalidomide in chronic graft\u2010versus\u2010host disease showed benefit in children and adults as treatment, but not as prophylaxis. The agent has been administered successfully for treatment of cachexia related to cancer, tuberculosis, and human immunodeficiency virus infection, although evidence of efficacy is inconclusive. Thalidomide monotherapy effectively induced objective response in trials in patients with both newly diagnosed and advanced or refractory multiple myeloma. Combination therapy with thalidomide and corticosteroids was also effective in these patients, as well as in treatment of aphthous and genital ulcers. Limited evidence supports the drug's benefit in treatment of Kaposi's sarcoma. Other thalidomide applications include Crohn's disease, rheumatoid arthritis, and multiple sclerosis. Somnolence, constipation, and rash were the most frequently cited adverse effects in studies, but thalidomide\u2010induced neuropathy and idiopathic thromboembolism were critical causes for drug discontinuation. Thalidomide is still contraindicated in pregnant women, women of childbearing age, and sexually active men not using contraception. Clinicians should be conversant with thalidomide in ENL (its primary application) in the natural course of leprosy, as well as in the agent's other applications.<\/jats:p>","DOI":"10.1592\/phco.23.4.481.32115","type":"journal-article","created":{"date-parts":[[2004,5,11]],"date-time":"2004-05-11T08:01:46Z","timestamp":1084262506000},"page":"481-493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Thalidomide for Erythema Nodosum Leprosum and Other Applications"],"prefix":"10.1002","volume":"23","author":[{"given":"Mark C.","family":"Okafor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,16]]},"reference":[{"issue":"9","key":"e_1_2_1_2_2","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/j.1742-1241.2001.tb11143.x","article-title":"Thalidomide: 40 years on","volume":"55","author":"Diggle GE","year":"2001","journal-title":"Int J Clin Pract"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.10.872"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200060020-00003"},{"key":"e_1_2_1_5_2","first-page":"303","volume-title":"Harrison's principles of internal medicine, 13th ed, vol 1","author":"Bolognia J","year":"1994"},{"key":"e_1_2_1_6_2","first-page":"718","volume-title":"Harrison's principles of internal medicine, 13th ed, vol 1","author":"Miller RA","year":"1994"},{"key":"e_1_2_1_7_2","first-page":"1","article-title":"WHO expert committee on leprosy","volume":"874","author":"World Health Organization.","year":"1998","journal-title":"World Health Organ Tech Rep Ser"},{"key":"e_1_2_1_8_2","unstructured":"Centers for Disease Control and Prevention.Hansen's disease (leprosy). Division of Bacterial and Mycotic Diseases\u2014Disease Information. Available fromhttp:www.cdc.govncidoddbmddiseaseinfohansens_t.html. Accessed December 1 2000."},{"key":"e_1_2_1_9_2","first-page":"112","article-title":"Global disease elimination and eradication as public health strategies","volume":"48","author":"Centers for Disease Control and Prevention.","year":"1999","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_1_10_2","first-page":"1696","volume-title":"Cecil textbook of internal medicine","author":"Bullock WE","year":"1988"},{"key":"e_1_2_1_11_2","first-page":"270","article-title":"Risk factors for erythema nodosum leprosum","volume":"67","author":"Manandhar R","year":"1999","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4684-1009-9_15"},{"key":"e_1_2_1_13_2","first-page":"37","article-title":"Daily multidrug therapy for leprosy; results of a fourteen\u2010year experience","volume":"65","author":"Carsalade GY","year":"1997","journal-title":"Int J Lepr"},{"key":"e_1_2_1_14_2","first-page":"S111","article-title":"Steroids in leprosy type I (reversal reactions: mechanisms of action and effectiveness)","volume":"71","author":"Lockwood DN","year":"2000","journal-title":"Lepr Rev"},{"key":"e_1_2_1_15_2","volume-title":"Chemotherapy of leprosy for control programmes","author":"World Health Organization.","year":"1982"},{"key":"e_1_2_1_16_2","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1128\/AAC.41.9.1953","article-title":"High relapse rate among lepromatous leprosy patients treated with rifampin plus ofloxacin daily for 4 weeks","volume":"41","author":"Ji B","year":"1997","journal-title":"Antimicrob Agents Chemother"},{"key":"e_1_2_1_17_2","unstructured":"Celgene Pharmaceuticals Inc.Thalidomide package insert. Warren NJ;1999."},{"key":"e_1_2_1_18_2","first-page":"350","article-title":"The impact of multiple drug therapy on leprosy disabilities","volume":"68","author":"Willcox ML","year":"1997","journal-title":"Lepr Rev"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.187.11.1885"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1159\/000023926"},{"key":"e_1_2_1_21_2","first-page":"719","article-title":"WHO coordinated short\u2010term double\u2010blind trial with thalidomide in the treatment of acute lepra reactions in male lepromatous patients","volume":"45","author":"Iyer GCS","year":"1971","journal-title":"Bull WHO"},{"issue":"2","key":"e_1_2_1_22_2","first-page":"135","article-title":"Results of a double\u2010blind study of the influence of thalidomide on lepra reaction","volume":"37","author":"Sheskin J","year":"1969","journal-title":"Int J Lepr"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.5935\/0305-7518.19710004"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt1970114481"},{"key":"e_1_2_1_25_2","unstructured":"U.S. Food and Drug Administration Center for Drug Evaluation and Research.Thalidomide information. FDA's medical review of thalidomide clinical development. Available fromhttp:www.fda.govcdernewsthalinfo. Accessed July 7 1998."},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-2478(99)00055-3"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/088922299310269"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1996.0181"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)00408-8"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701138"},{"key":"e_1_2_1_31_2","first-page":"937","article-title":"Thalidomide in the management of chronic graft\u2010versus\u2010host disease in children following bone marrow transplantation","volume":"14","author":"Cole CH","year":"1994","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_1_32_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.103.4.e44"},{"key":"e_1_2_1_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702626"},{"key":"e_1_2_1_34_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.12.3995"},{"key":"e_1_2_1_35_2","first-page":"86","article-title":"Paradoxical effect of thalidomide prophylaxis on chronic graft\u2010versus\u2010host disease","volume":"2","author":"Chao NJ","year":"1996","journal-title":"Biol Blood Marrow Transplant"},{"issue":"6","key":"e_1_2_1_36_2","first-page":"53","article-title":"Anticytokine approaches to the treatment of anorexia and cachexia","volume":"25","author":"Haslett PA","year":"1998","journal-title":"Semin Oncol"},{"key":"e_1_2_1_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn.70.2.183"},{"key":"e_1_2_1_38_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.13.2593"},{"key":"e_1_2_1_39_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199705223362103"},{"key":"e_1_2_1_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1085-5629(97)80020-X"},{"key":"e_1_2_1_41_2","first-page":"769","article-title":"An evaluation of a chemical cautery agent and an anti\u2010inflammatory ointment for the treatment of recurrent aphthous stomatitis: a pilot study","volume":"29","author":"Rhodus NL","year":"1998","journal-title":"Quintessence Int"},{"key":"e_1_2_1_42_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-109-4-338"},{"key":"e_1_2_1_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0248-8663(99)80105-2"},{"key":"e_1_2_1_44_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.1997.13.301"},{"key":"e_1_2_1_45_2","first-page":"169","article-title":"Thalidomide for treatment of oral aphthous ulcers in patients with human immunodeficiency virus: case report and review","volume":"92","author":"Ball SC","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_1_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70523-2"},{"key":"e_1_2_1_47_2","first-page":"3451","volume-title":"AHFS drug information 2000","author":"McEvoy GK","year":"2000"},{"issue":"1","key":"e_1_2_1_48_2","first-page":"165","article-title":"Expression of angiogenic factors including VEGFs and the effects of hypoxia and thalidomide on human myeloma cells","volume":"22","author":"Yata K","year":"2003","journal-title":"Int J Oncol"},{"key":"e_1_2_1_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-002-0013-4"},{"key":"e_1_2_1_50_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911183412102"},{"key":"e_1_2_1_51_2","first-page":"404","article-title":"Thalidomide treatment of resistant or relapsed multiple myeloma patients","volume":"86","author":"Hus M","year":"2001","journal-title":"Hematologica"},{"key":"e_1_2_1_52_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdf188"},{"key":"e_1_2_1_53_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.02.116"},{"key":"e_1_2_1_54_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.9.2943"},{"key":"e_1_2_1_55_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2402183"},{"key":"e_1_2_1_56_2","first-page":"3377","article-title":"Dose\u2010dependent effect of thalidomide on overall survival in relapsed multiple myeloma","volume":"8","author":"Neben K","year":"2002","journal-title":"Clin Cancer Res"},{"key":"e_1_2_1_57_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199958010-00003"},{"key":"e_1_2_1_58_2","doi-asserted-by":"publisher","DOI":"10.1054\/mehy.1997.0719"},{"key":"e_1_2_1_59_2","doi-asserted-by":"publisher","DOI":"10.1089\/088922299310269"},{"key":"e_1_2_1_60_2","doi-asserted-by":"crossref","first-page":"5258","DOI":"10.1128\/IAI.67.10.5258-5264.1999","article-title":"Role of Leishmania donovani and its lipophosglycan in CD4+ T\u2010cell activation\u2010induced HIV replication","volume":"67","author":"Wolday D","year":"1999","journal-title":"Infect Immun"},{"key":"e_1_2_1_61_2","doi-asserted-by":"publisher","DOI":"10.1080\/000155500750012450"},{"key":"e_1_2_1_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(94)80092-8"},{"key":"e_1_2_1_63_2","doi-asserted-by":"publisher","DOI":"10.1159\/000187978"},{"key":"e_1_2_1_64_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.135.9.1079"},{"key":"e_1_2_1_65_2","first-page":"1596","article-title":"Sub\u2010acute cutaneous lupus. Evolutive and therapeutic features of a series of 24 cases","volume":"29","author":"Versapuech J","year":"2000","journal-title":"Presse Med"},{"key":"e_1_2_1_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)02197-7"},{"key":"e_1_2_1_67_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.1997.13.857"},{"key":"e_1_2_1_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91221-F"},{"key":"e_1_2_1_69_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdf258"},{"key":"e_1_2_1_70_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199207020-00004"},{"key":"e_1_2_1_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0248-8663(02)00648-3"},{"key":"e_1_2_1_72_2","doi-asserted-by":"publisher","DOI":"10.1080\/10245330290020126"},{"key":"e_1_2_1_73_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10847"},{"key":"e_1_2_1_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01300-1"},{"key":"e_1_2_1_75_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-960X(02)00031-0"},{"issue":"10","key":"e_1_2_1_76_2","first-page":"1355","article-title":"Thalidomide is distributed into human semen after oral dosing","volume":"29","author":"Teo SK","year":"2001","journal-title":"Drug Metab Dispos"},{"key":"e_1_2_1_77_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1529-8027.2001.006001008.x"},{"key":"e_1_2_1_78_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1529-8027.2001.006001002.x"},{"key":"e_1_2_1_79_2","first-page":"10","article-title":"Stavudine: a review","volume":"2","author":"Fuchs JE","year":"1998","journal-title":"Braz J Infect Dis"},{"key":"e_1_2_1_80_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199958060-00009"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1592%2Fphco.23.4.481.32115","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1592\/phco.23.4.481.32115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:44:45Z","timestamp":1761054285000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1592\/phco.23.4.481.32115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,4]]},"references-count":79,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2003,4]]}},"alternative-id":["10.1592\/phco.23.4.481.32115"],"URL":"https:\/\/doi.org\/10.1592\/phco.23.4.481.32115","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,4]]},"assertion":[{"value":"2012-01-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}