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[沙利度胺和来那度胺的当前治疗适应证]

[Current therapeutic indications of thalidomide and lenalidomide].

作者信息

Ordi-Ros Josep, Cosiglio Francisco Javier

机构信息

Servicio de Medicina Interna, Hospital Vall d'Hebron, Instituto de Investigación Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.

Servicio de Clínica Médica, Hospital Provincial del Centenario, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina.

出版信息

Med Clin (Barc). 2014 Apr 22;142(8):360-4. doi: 10.1016/j.medcli.2013.04.038. Epub 2013 Jul 3.

Abstract

Thalidomide is a synthetic glutamic acid derivative first introduced in 1956 in Germany as an over the counter medications. It was thought to be one of the safest sedatives ever produced as it was effective in small doses, was not addictive, and did not have acute side-effects such as motor impairment, but was quickly removed from market after it was linked to cases of severe birth defects. The Food and Drug Administration approved use in the treatment of erythema nodosum leprosum. Further, it was shown its effectiveness in unresponsive dermatological conditions such as actinic prurigo, adult Langerhans cell hystiocytosis, aphthous stomatitis, Behçet syndrome, graft-versus-host disease, cutaneous sarcoidosis, erythema multiforme, Jessner-Kanof lymphocytic infiltration of the skin, Kaposi sarcoma, lichen planus, lupus erythematosus, melanoma, prurigo nodularis, pyoderma gangrenosum and others. In May 2006, it was approved for the treating multiple myeloma. New thalidomide analogues have been developed but lack clinical experience. This paper is a review of the history, pharmacology, mechanism of action, clinical applications and side effects of thalidomide and its analogues.

摘要

沙利度胺是一种合成谷氨酸衍生物,1956年在德国首次作为非处方药推出。它被认为是有史以来最安全的镇静剂之一,因为它小剂量有效,无成瘾性,且没有诸如运动障碍等急性副作用,但在与严重出生缺陷病例相关联后很快就被撤出市场。美国食品药品监督管理局批准其用于治疗麻风结节性红斑。此外,还显示出它在治疗无反应性皮肤病方面的有效性,如光化性痒疹、成人朗格汉斯细胞组织细胞增多症、阿弗他口炎、白塞病、移植物抗宿主病、皮肤结节病、多形红斑、耶斯纳-卡诺夫皮肤淋巴细胞浸润、卡波西肉瘤、扁平苔藓、红斑狼疮、黑色素瘤、结节性痒疹、坏疽性脓皮病等。2006年5月,它被批准用于治疗多发性骨髓瘤。新型沙利度胺类似物已被研发出来,但缺乏临床经验。本文是对沙利度胺及其类似物的历史、药理学、作用机制、临床应用和副作用的综述。

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