Effective treatment of gastrointestinal bleeding with thalidomide - Chances and limitations

Core Tip

Core tip: Traditionally, bleeding from gastrointestinal angiodysplasias has been treated by hormonal therapy. After a randomized study finally demonstrated that hormones are not efficient, treatment has switched to endoscopic coagulation techniques. Thalidomide was recently proven to be highly effective for treatment of bleeding from gastrointestinal angiodysplasias and is also useful for bleeding in hereditary hemorrhagic telangiectasia. However, thalidomide is rarely used as it is still notorious for its teratogenicity. Patients with gastrointestinal bleeding related to angiodysplasias are generally old and teratogenicity is not an important issue. Other side-effects of thalidomide like neurotoxicity may limit treatment options but can be monitored safely.