https://observatorio.fm.usp.br/handle/OPI/40865
Title: | One-year prospective nerve conduction study of thalidomide neuropathy in lupus erythematosus: Incidence, coasting effect and drug plasma levels |
Authors: | YUKI, Emily Figueiredo Neves; SOARES, Renata; KUPA, Leonard de Vinci Kanda; HEISE, Carlos Otto; AIKAWA, Nadia Emi; ARNONE, Marcelo; ROMITI, Ricardo; PEDROSA, Tatiana do Nascimento; SILVA, Clovis Artur Almeida da; BONFA, Eloisa; PASOTO, Sandra Gofinet |
Citation: | LUPUS, v.30, n.6, p.956-964, 2021 |
Abstract: | Background Few prospective studies in cutaneous and systemic lupus erythematosus (CLE/SLE) assessed thalidomide-induced peripheral neuropathy (TiPN) incidence/reversibility, and most have not excluded confounding causes neither monitored thalidomide plasma levels. Objectives To evaluate TiPN incidence/reversibility, coasting effect and its association with thalidomide plasma levels in CLE/SLE. Methods One-year prospective study of thalidomide in 20 CLE/SLE patients without pregnancy potential, with normal nerve conduction study (NCS), and excluded other PN causes. Thalidomide levels were determined by high-performance liquid chromatography/tandem mass spectrometry. Results Twelve patients (60%) developed TiPN: 33.3% were symptomatic and 66.6% asymptomatic. Half of this latter group developed coasting effect (TiPN symptoms 1-3 months after drug withdrawal). The main predictive factors for TiPN were treatment duration >= 6 months (p = 0.025) and cumulative dose (p = 0.023). No difference in plasma thalidomide levels between patients with/without TiPN was observed (p = 0.464). After drug withdrawal, 75% symptomatic TiPN patients improved their symptoms. Seven TiPN patients underwent an additional NCS after drug withdrawal: 42.8% worsened NCS, 14.2% was stable, and 42.8% had improved NCS. Conclusion Our data provides novel evidence of coasting effect in half of asymptomatic patients with TiPN. The irreversible nature of this lesion in 25% of TiPN patients reinforces the relevance of early NCS monitoring, and suggests thalidomide use solely as a bridge for other effective therapy for refractory cutaneous lupus patients. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - FM/MPE Artigos e Materiais de Revistas Científicas - FM/Outros Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/ICr Artigos e Materiais de Revistas Científicas - HC/IOT Artigos e Materiais de Revistas Científicas - LIM/03 Artigos e Materiais de Revistas Científicas - LIM/15 Artigos e Materiais de Revistas Científicas - LIM/17 Artigos e Materiais de Revistas Científicas - LIM/36 Artigos e Materiais de Revistas Científicas - LIM/50 |
File | Description | Size | Format | |
---|---|---|---|---|
art_YUKI_Oneyear_prospective_nerve_conduction_study_of_thalidomide_neuropathy_2021.PDF Restricted Access | publishedVersion (English) | 468.8 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.