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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorYUKI, Emily Figueiredo Neves-
dc.contributor.authorSILVA, Clovis A.-
dc.contributor.authorAIKAWA, Nadia E.-
dc.contributor.authorROMITI, Ricardo-
dc.contributor.authorHEISE, Carlos Otto-
dc.contributor.authorBONFA, Eloisa-
dc.contributor.authorPASOTO, Sandra Gofinet-
dc.identifier.citationJCR-JOURNAL OF CLINICAL RHEUMATOLOGY, v.27, n.6, p.248-259, 2021-
dc.description.abstractBackground: Thalidomide has shown exceptional results in systemic/cutaneous lupus erythematosus(SLE/CLE). Recently, lenalidomide has been also prescribed for SLE/CLE treatment. Literature regarding efficacy/adverse events for these drugs is scarce with a single systematic review and meta-analysis focused solely on thalidomide for refractory cutaneous lupus subtypes. Objective: We, therefore, addressed in this narrative review the efficacy/adverse effects of thalidomide and lenalidomide for SLE and CLE. In addition, we provide a specialist approach for clinical practice based on the available evidence. Results: Efficacy of thalidomide for refractory cutaneous lupus treatment was demonstrated by several studies, mostly retrospective with small sample size(<= 20). The frequency of peripheral polyneuropathy is controversial varying from 15-80% with no consistent data regarding cumulative dose and length of use. Drug withdrawn results in clinical partial/complete reversibility for most cases (70%). For lenalidomide, seven studies (small sample sizes) reported its efficacy for SLE/CLE with complete/partial response in all patients with a mean time to response of 3 months. Flare rate varied from 25-75% occurring 0.5-10 months after drug withdrawn. There were no reports of polyneuropathy/worsening of previous thalidomide-induced neuropathy, but most of them did not perform nerve conduction studies. Teratogenicity risk exist for both drugs and strict precautions are required. Conclusions: Thalidomide is very efficacious as an induction therapy for patients with severe/refractory cutaneous lupus with high risk of scarring, but its longstanding use should be avoided due to neurotoxicity. Lenalidomide is a promising drug for skin lupus treatment, particularly regarding the apparent lower frequency of nerve side effects.eng
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao PauloFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2015/03756-4]-
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e TecnologicoConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPQ) [305068/2014-8, 303422/2015-7]-
dc.relation.ispartofJcr-Journal of Clinical Rheumatology-
dc.subjectcutaneous lupus erythematosuseng
dc.subjectperipheral neuropathyeng
dc.subjectsystemic lupus erythematosuseng
dc.subject.otherlow-dose thalidomideeng
dc.subject.otherinduced peripheral neuropathyeng
dc.subject.othercutaneous lupuseng
dc.subject.otherseverity indexeng
dc.subject.othersensory neurotoxicityeng
dc.subject.other2nd-line treatmenteng
dc.titleThalidomide and Lenalidomide for Refractory Systemic/Cutaneous Lupus Erythematosus Treatment A Narrative Review of Literature for Clinical Practiceeng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
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Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - FM/MPE
Departamento de Pediatria - FM/MPE

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/ICr
Instituto da Criança - HC/ICr

Artigos e Materiais de Revistas Científicas - HC/IOT
Instituto de Ortopedia e Traumatologia - HC/IOT

Artigos e Materiais de Revistas Científicas - LIM/03
LIM/03 - Laboratório de Medicina Laboratorial

Artigos e Materiais de Revistas Científicas - LIM/15
LIM/15 - Laboratório de Investigação em Neurologia

Artigos e Materiais de Revistas Científicas - LIM/17
LIM/17 - Laboratório de Investigação em Reumatologia

Artigos e Materiais de Revistas Científicas - LIM/36
LIM/36 - Laboratório de Pediatria Clínica

Artigos e Materiais de Revistas Científicas - LIM/50
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas

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