antiquity
11-17-2001, 09:47 AM
Friday November 16 1:59 PM ET
Thalidomide May Relieve Rare Pain Disorder: Report
By Merritt McKinney
NEW YORK (Reuters Health) - In a chance discovery, doctors at the Mayo Clinic have found that thalidomide--a drug banned in the 1960s for causing severe birth defects--may be an effective treatment for a mysterious form of disabling nerve pain.
Based on a case of a woman with the condition whose symptoms disappeared soon after she started taking thalidomide to treat blood cancer, the Mayo physicians recommend that clinical trials of thalidomide in reflex sympathetic dystrophy (RSD) patients be considered.
RSD causes pain, swelling and limited movement, most often in the limbs. It may develop after an injury, such as a broken bone, but the severity of the pain is out of proportion to the injury and continues even after the injury has healed.
Therapy for RSD is often ineffective and many people with the condition have a poor quality of life. That was the case for a 43-year-old woman seen by Dr. S. Vincent Rajkumar and colleagues at the Mayo Clinic in Rochester, Minnesota. After injuring her hand, the woman developed a severe case of RSD that confined her to bed or a wheelchair most of the time.
Three years after developing RSD, the woman was diagnosed with a type of blood cancer called multiple myeloma. Rajkumar and his colleagues started the woman on thalidomide, which has shown promise for treating the blood cancer.
The change in the woman's condition was ``astounding,'' Rajkumar told Reuters Health in an interview.
Within a month, the woman experienced an unexpected improvement in RSD symptoms, which nearly disappeared, Rajkumar and his colleagues report in the November 12th issue of the journal Archives of Internal Medicine (news - web sites).
Ulcers and swelling on her legs healed completely, and she was able to abandon her wheelchair. During the following few months, the woman was able to use her left hand again, and she stopped all treatments for pain.
The woman's blood cancer also improved, although the benefits of thalidomide were more gradual for the cancer than for her pain, according to the report.
Rajkumar and his associates are not sure how thalidomide improved RSD, although they suggest that the drug's ``remarkable benefit'' may result not only from its effect on nerves but also its ability to reduce inflammation.
``There's really no good treatment for these patients,'' Rajkumar said. ``We would recommend that people start doing some clinical trials'' of thalidomide in patients with RSD, he said.
Rajkumar's team is currently planning such a trial, which will include 15 patients with the condition.
So far, the patient in the report has not experienced any major side effects of treatment, Rajkumar said. She continues to take a low dose of the drug. According to the Mayo researcher, there is ``no evidence that the RSD is coming back.''
SOURCE: Archives of Internal Medicine 2001;161:2502-2503.
Thalidomide May Relieve Rare Pain Disorder: Report
By Merritt McKinney
NEW YORK (Reuters Health) - In a chance discovery, doctors at the Mayo Clinic have found that thalidomide--a drug banned in the 1960s for causing severe birth defects--may be an effective treatment for a mysterious form of disabling nerve pain.
Based on a case of a woman with the condition whose symptoms disappeared soon after she started taking thalidomide to treat blood cancer, the Mayo physicians recommend that clinical trials of thalidomide in reflex sympathetic dystrophy (RSD) patients be considered.
RSD causes pain, swelling and limited movement, most often in the limbs. It may develop after an injury, such as a broken bone, but the severity of the pain is out of proportion to the injury and continues even after the injury has healed.
Therapy for RSD is often ineffective and many people with the condition have a poor quality of life. That was the case for a 43-year-old woman seen by Dr. S. Vincent Rajkumar and colleagues at the Mayo Clinic in Rochester, Minnesota. After injuring her hand, the woman developed a severe case of RSD that confined her to bed or a wheelchair most of the time.
Three years after developing RSD, the woman was diagnosed with a type of blood cancer called multiple myeloma. Rajkumar and his colleagues started the woman on thalidomide, which has shown promise for treating the blood cancer.
The change in the woman's condition was ``astounding,'' Rajkumar told Reuters Health in an interview.
Within a month, the woman experienced an unexpected improvement in RSD symptoms, which nearly disappeared, Rajkumar and his colleagues report in the November 12th issue of the journal Archives of Internal Medicine (news - web sites).
Ulcers and swelling on her legs healed completely, and she was able to abandon her wheelchair. During the following few months, the woman was able to use her left hand again, and she stopped all treatments for pain.
The woman's blood cancer also improved, although the benefits of thalidomide were more gradual for the cancer than for her pain, according to the report.
Rajkumar and his associates are not sure how thalidomide improved RSD, although they suggest that the drug's ``remarkable benefit'' may result not only from its effect on nerves but also its ability to reduce inflammation.
``There's really no good treatment for these patients,'' Rajkumar said. ``We would recommend that people start doing some clinical trials'' of thalidomide in patients with RSD, he said.
Rajkumar's team is currently planning such a trial, which will include 15 patients with the condition.
So far, the patient in the report has not experienced any major side effects of treatment, Rajkumar said. She continues to take a low dose of the drug. According to the Mayo researcher, there is ``no evidence that the RSD is coming back.''
SOURCE: Archives of Internal Medicine 2001;161:2502-2503.