Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

One-year prospective nerve conduction study of thalidomide neuropathy in lupus erythematosus: Incidence, coasting effect and drug plasma levels

Full text
Author(s):
Show less -
Yuki, Emily Figueiredo Neves [1] ; Soares, Renata [2] ; Kupa, Leonard de Vinci Kanda [2] ; Heise, Carlos Otto [3] ; Aikawa, Nadia Emi [1] ; Arnone, Marcelo [4] ; Romiti, Ricardo [4] ; Pedrosa, Tatiana do Nascimento [1] ; Silva, Clovis Artur Almeida da [1] ; Bonfa, Eloisa [1] ; Pasoto, Sandra Gofinet [1]
Total Authors: 11
Affiliation:
[1] Univ Sao Paulo, Rheumatol Div, Fac Med, Hosp Clin HCFMUSP, Sao Paulo - Brazil
[2] Univ Sao Paulo, Div Cent Lab, Fac Med, Hosp Clin HCFMUSP, Sao Paulo - Brazil
[3] Univ Sao Paulo, Neurol Dept, Fac Med, Hosp Clin HCFMUSP, Sao Paulo - Brazil
[4] Univ Sao Paulo, Dermatol Dept, Fac Med, Hosp Clin HCFMUSP, Sao Paulo - Brazil
Total Affiliations: 4
Document type: Journal article
Source: Lupus; v. 30, n. 6 MAR 2021.
Web of Science Citations: 0
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. (AU)

FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
Grantee:Eloisa Silva Dutra de Oliveira Bonfá
Support Opportunities: Research Projects - Thematic Grants
FAPESP's process: 19/17272-0 - Relevance of monitoring blood levels compared to salivar levels of drugs used in rheumatic autoimmune diseases: adherence and understanding the possible underlying mechanisms involved in effectiveness and in adverse effects
Grantee:Leonard de Vinci Kanda Kupa
Support Opportunities: Scholarships in Brazil - Post-Doctoral
FAPESP's process: 17/14352-7 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
Grantee:Tatiana Do Nascimento Pedrosa
Support Opportunities: Scholarships in Brazil - Post-Doctoral