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Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports

INTRODUCTION: Thalidomide is an anti- tumor necrosis factor alpha (TNF-a) drug used mainly in the management of moderate to severe form of Erythema Nodosum Leprosum (ENL). Because of its teratogenic potential it has to be used under proper supervision. Our critical analysis tries to look into the ra...

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Autores principales: Thangaraju, Pugazhenthan, Venkatesan, Sajitha, Gurunthalingam, Meenalotchini, Babu, Shoban, T, Tamilselvan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Medicina Tropical - SBMT 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491565/
https://www.ncbi.nlm.nih.gov/pubmed/32935774
http://dx.doi.org/10.1590/0037-8682-0454-2019
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author Thangaraju, Pugazhenthan
Venkatesan, Sajitha
Gurunthalingam, Meenalotchini
Babu, Shoban
T, Tamilselvan
author_facet Thangaraju, Pugazhenthan
Venkatesan, Sajitha
Gurunthalingam, Meenalotchini
Babu, Shoban
T, Tamilselvan
author_sort Thangaraju, Pugazhenthan
collection PubMed
description INTRODUCTION: Thalidomide is an anti- tumor necrosis factor alpha (TNF-a) drug used mainly in the management of moderate to severe form of Erythema Nodosum Leprosum (ENL). Because of its teratogenic potential it has to be used under proper supervision. Our critical analysis tries to look into the rationale with which it has been used by means of case reports on lepra reaction. METHODS: We looked for the case reports between December 2005 to June 2019 in databases like Pubmed, Embase and other relevant resources. We used search words like “erythema nodosum leprosum(ENL)”, “thalidomide”, “case report” in different combinations to get relevant reports that focus on thalidomide usage atleast once at any time point during management. The information extracted were indication of thalidomide use, dose, response, outcome, complication if any, along with all the demographic details and geographical distribution. RESULTS: We found 41 case reports eligible for analysis.The information was critically evaluated. From the analysis it was found that 7 of the case report mentioned the exact indication, 4 case report showed irrational use of thalidomide in the case of neuritis without use of steroids, 7 showed proper use of Clofazimine prior to thalidomide initiation, 26 case report showed case report of rationale dose range and in 4 case reports clofazimine was used prior to thalidomide along with the rational dose of thalidomide. CONCLUSIONS: This analysis helps to guide the rationale use of thalidomide focussing on few important points that anyone should keep in mind while managing a case of ENL.
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spelling pubmed-74915652020-09-16 Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports Thangaraju, Pugazhenthan Venkatesan, Sajitha Gurunthalingam, Meenalotchini Babu, Shoban T, Tamilselvan Rev Soc Bras Med Trop Major Article INTRODUCTION: Thalidomide is an anti- tumor necrosis factor alpha (TNF-a) drug used mainly in the management of moderate to severe form of Erythema Nodosum Leprosum (ENL). Because of its teratogenic potential it has to be used under proper supervision. Our critical analysis tries to look into the rationale with which it has been used by means of case reports on lepra reaction. METHODS: We looked for the case reports between December 2005 to June 2019 in databases like Pubmed, Embase and other relevant resources. We used search words like “erythema nodosum leprosum(ENL)”, “thalidomide”, “case report” in different combinations to get relevant reports that focus on thalidomide usage atleast once at any time point during management. The information extracted were indication of thalidomide use, dose, response, outcome, complication if any, along with all the demographic details and geographical distribution. RESULTS: We found 41 case reports eligible for analysis.The information was critically evaluated. From the analysis it was found that 7 of the case report mentioned the exact indication, 4 case report showed irrational use of thalidomide in the case of neuritis without use of steroids, 7 showed proper use of Clofazimine prior to thalidomide initiation, 26 case report showed case report of rationale dose range and in 4 case reports clofazimine was used prior to thalidomide along with the rational dose of thalidomide. CONCLUSIONS: This analysis helps to guide the rationale use of thalidomide focussing on few important points that anyone should keep in mind while managing a case of ENL. Sociedade Brasileira de Medicina Tropical - SBMT 2020-09-11 /pmc/articles/PMC7491565/ /pubmed/32935774 http://dx.doi.org/10.1590/0037-8682-0454-2019 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Major Article
Thangaraju, Pugazhenthan
Venkatesan, Sajitha
Gurunthalingam, Meenalotchini
Babu, Shoban
T, Tamilselvan
Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
title Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
title_full Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
title_fullStr Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
title_full_unstemmed Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
title_short Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
title_sort rationale use of thalidomide in erythema nodosum leprosum - a non-systematic critical analysis of published case reports
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491565/
https://www.ncbi.nlm.nih.gov/pubmed/32935774
http://dx.doi.org/10.1590/0037-8682-0454-2019
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