A pilot study of thalidomide in recurrent GI bleeding due to angiodysplasias

Angiodysplasias are a major cause of lower gastrointestinal bleeding in patients over the age of 60 years. Although multiple treatment modalities, both medical and surgical, are being used, there is no effective treatment option currently available. Our study defines the use of a novel drug that might be effective against bleeding from vascular malformations. Three patients with a diagnosis of angiodysplasia, who were transfusion dependent, were placed on the study drug. The need for blood transfusions was recorded over the study period and for 6 months after the end of the study. We saw a decreased need for transfusions within 12 weeks of starting the treatment in two patients, and they continued to remain free of transfusion requirement during the immediate follow-up period. The study drug was well tolerated. Thalidomide, with its antiangiogenic mechanism of action, seems to be a promising drug in bleeding angiodysplasias as a treatment option for patients unable to benefit from other available modalities of treatment.