Combe B
Rheumatology Federation, Hôpital Lapeyronie, Montpellier, France.
Joint Bone Spine. 2001 Dec;68(6):582-7. doi: 10.1016/s1297-319x(01)00326-8.
Thalidomide, which was developed as a nonbarbiturate sedative agent, was taken off the market in 1961 after it was linked to a spate of major birth defects. Gradually, thalidomide was reintroduced for the treatment of a few skin diseases including leprous erythema nodosum, severe mucosal ulcers (e.g., associated with HIV infection or Behçet's disease), lymphocytic skin infiltrations, cutaneous lupus erythematosus, and chronic graft-versus-host disease. Recent reports of original pharmacological properties including modulation of cytokine production (mainly reduced TNF-alpha production) and inhibition of angiogenesis have led to the suggestion that thalidomide may be useful in some inflammatory and neoplastic conditions. Several open-label studies and case reports have described the effects of thalidomide in Crohn's disease, rheumatoid arthritis, ankylosing spondylarthritis, systemic sclerosis, and a few other systemic disorders. In these indications, minor but dose-limiting side effects were apparently common. Thalidomide analogs with better acceptability profiles are under evaluation. The anti-angiogenic effects of thalidomide may make this compound valuable as single-drug therapy or as an adjunct to chemotherapy in patients with cancer, particularly those with metastases or multiple myeloma. This possibility requires further evaluation.
沙利度胺最初是作为一种非巴比妥类镇静剂开发的，在与一系列严重出生缺陷相关联后，于1961年退出市场。渐渐地，沙利度胺被重新用于治疗一些皮肤病，包括麻风性结节性红斑、严重黏膜溃疡（如与HIV感染或白塞病相关的溃疡）、淋巴细胞性皮肤浸润、皮肤红斑狼疮以及慢性移植物抗宿主病。最近关于其原始药理特性的报道，包括调节细胞因子产生（主要是减少肿瘤坏死因子-α的产生）和抑制血管生成，提示沙利度胺可能在某些炎症和肿瘤性疾病中有用。几项开放标签研究和病例报告描述了沙利度胺在克罗恩病、类风湿关节炎、强直性脊柱炎、系统性硬化症以及其他一些全身性疾病中的作用。在这些适应证中，轻微但限制剂量的副作用显然很常见。具有更好耐受性的沙利度胺类似物正在评估中。沙利度胺的抗血管生成作用可能使该化合物作为单一药物治疗或作为癌症患者（尤其是有转移或多发性骨髓瘤的患者）化疗的辅助药物具有价值。这种可能性需要进一步评估。
