Crossover study of thalidomide vs placebo in severe recurrent aphthous stomatitis

High-Level Expression of Vascular Endothelial Growth Factor and Its Receptors in an Aphthous Ulcer

“…1 Recently, thalidomide has been found to be highly effective in the treatment of aphthous ulceration in HIVpositive patients. [2][3][4][5][6] Thalidomide has multiple modes of action, including inhibition of tumor necrosis factor and angiogenesis inhibition, but the precise mode of thalidomide activity in aphthous ulcer disease is unknown. 7,8 In order to determine whether aphthous ulcers exhibit a deficit or increase in angiogenic factors, an active aphthous ulcer from the mouth of the first author was subjected to in situ hybridization for the angiogenic factors vascular endothelial growth factor (VEGF), its receptors VEGFR1 (flt), VEGFR2 (flk/kdr), and angiopoietin 2, and its receptors TIE1 and TIE2.…”

Complex aphthosis: A large case series with evaluation algorithm and therapeutic ladder from topicals to thalidomide

“…Patients with recalcitrant disease were next offered thalidomide, and were monitored monthly according to the System for thalidomide education and prescribing safety (STEPS). [74][75][76] Seventeen patients were treated with thalidomide in doses ranging from 50 mg to 150 mg nightly, and 10 patients remained on therapy at the end of the monitoring period with partial or complete response. Adverse effects ascribed to thalidomide therapy included neuropathy with nerve conduction abnormality in 2 patients, drug eruption in one patient, and headache in one patient.…”

Thalidomide in Low Intermittent Doses Does Not Prevent Recurrence of Human Immunodeficiency Virus–Associated Aphthous Ulcers

“…Hence, these studies measured a mixture of treatment and prevention effects of thalidomide. In one placebo-controlled crossover trial with no washout period before crossover, 17 (45%) of 38 thalidomide-treated patients had complete healing of ulcers present and remained free of at Georgetown University on May 23, 2015 http://jid.oxfordjournals.org/ Downloaded from ulcers during the first 2-month treatment period [9]. This occurred in 1 (3%) of 35 who received placebo.…”