Prescrire Int. 1998 Oct;7(37):131-4.
(1) Thalidomide is highly teratogenic. It can also cause irreversible neuropathy. (2) In type II lepra reactions evidence of efficacy at a dose of 400 mg/day is based on a few relatively old comparative trials and above all a review of more than 4,500 cases. Most patients feel a benefit within 24-48 hours after beginning the treatment, but most also require lengthy treatment at a reduced dose (25-100 mg/day) to avoid relapses. (3) Two placebo-controlled trials involving a total of 130 patients have shown the efficacy of thalidomide in the treatment of severe recurrent aphthous disease. (4) In Jessner-Kanoff disease, a mild condition, the efficacy of thalidomide has been shown in a single placebo-controlled trial. (5) In chronic lupus erythematosus, non comparative trials have shown remission from skin lesions in patients resistant to previous treatments. (6) In the curative treatment of chronic graft-versus-host disease in bone marrow graft recipients, thalidomide has been assessed only in non comparative trials involving a few dozens of patients.
（1）沙利度胺具有高度致畸性。它还可导致不可逆的神经病变。（2）在Ⅱ型麻风反应中，每日400毫克剂量的疗效证据基于一些相对陈旧的对照试验，尤其是对4500多例病例的综述。大多数患者在开始治疗后24至48小时内会感觉病情改善，但大多数患者也需要以较低剂量（每日25至100毫克）进行长期治疗以避免复发。（3）两项共涉及130名患者的安慰剂对照试验已证明沙利度胺治疗重度复发性阿弗他病的疗效。（4）在病情较轻的杰斯纳 - 卡诺夫病中，一项安慰剂对照试验已证明沙利度胺的疗效。（5）在慢性红斑狼疮中，非对照试验表明，先前治疗无效的患者皮肤病变得到缓解。（6）在骨髓移植受者慢性移植物抗宿主病的治疗中，沙利度胺仅在涉及几十名患者的非对照试验中进行了评估。
