Abstract
Background
Thalidomide inhibits tumor necrosis factor (TNF)-α.
Purpose
To assess the effectiveness of thalidomide in the treatment of psoriasis.
Methods
Twenty subjects with moderate to severe psoriasis were treated with 200 mg of thalidomide daily. Clinical response was observed for 16 weeks with the last dose of thalidomide at 12 weeks.
Results
The severity of psoriasis improved as measured by both psoriasis area and severity index (PASI) and body surface area (BSA) with 40% having >50% improvement by 16 weeks. Mean PASI improvement at weeks 12 and 16 was 32% and 48%, respectively. Lower extremity edema developed in three of the first six patients enrolled, and the starting dose was amended from 200 mg/day to 100 mg/day.
Limitations
The open-label study design and concomitant therapy, albeit inadequately effective, complicates interpretation.
Conclusion
Thalidomide was effective and moderately well-tolerated in patients with psoriasis.
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