{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:48:29Z","timestamp":1791910109286,"version":"4.3.4"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Thalidomide, an anti-inflammatory and immunomodulatory agent, has a potential role in cases with central nervous system tuberculosis (CNS-TB) with paradoxical reactions. Although several articles have described the use of thalidomide in CNS-TB, no systematic review has been performed in this regard. Different electronic databases were searched for articles describing the use of thalidomide in patients with CNS-TB. For determining pooled estimates in the quantitative review, studies with a minimum sample size of 5 were only considered, whereas for qualitative synthesis even single case reports were included. Fixed or random effect models were used suitably depending on the degree of heterogeneity. Fourteen articles describing a total of 107 patients (98 children and 9 adults) were selected from 156 records. A favorable clinical response was observed in 89% of patients with CNS-TB who had paradoxical reactions refractory to corticosteroids. Majority of the studies used a dose of 2\u20136 mg\/kg\/day and around 24% suffered from at least one adverse effect, with a mortality of 5%. Predominant adverse effects were rash (9.5%), neuropathy (6%), and elevated liver transaminases (9.5%). Only one placebo-controlled trial has been performed till now, which showed that high-dose thalidomide has numerous adverse effects, without any clinically significant improvement as compared with placebo. While in HIV-positive patients with TB-immune reconstitution inflammatory syndrome thalidomide was helpful in around 82% of cases. Low-dose thalidomide is helpful in patients with CNS-TB who had a paradoxical reaction and unresponsive to corticosteroids. Large, randomized trials are needed to provide more concrete information regarding the safety and efficacy of thalidomide.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0108","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T09:54:42Z","timestamp":1627379682000},"page":"1024-1030","source":"Crossref","is-referenced-by-count":17,"title":["Efficacy and Safety of Thalidomide in Patients with Complicated Central Nervous System Tuberculosis: A Systematic Review and Meta-Analysis"],"prefix":"10.4269","volume":"105","author":[{"given":"Prateek Kumar","family":"Panda","sequence":"first","affiliation":[{"name":"1Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragnya","family":"Panda","sequence":"additional","affiliation":[{"name":"2Department of Neurology, King George Medical University, Lucknow, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesa","family":"Dawman","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh Kumar","family":"Sihag","sequence":"additional","affiliation":[{"name":"4Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indar Kumar","family":"Sharawat","sequence":"additional","affiliation":[{"name":"1Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/4\/article-p1024.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/105\/4\/article-p1024.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T14:40:57Z","timestamp":1633531257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/4\/article-p1024.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,6]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0108","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,6]]}}}