Angiodysplasia, a type of benign vascular lesion made up of dilated blood vessels, is a common source of gastrointestinal bleeding from the small intestine. A recent editorial from Yale Internal Medicine’s Loren Laine, MD, professor of medicine and chief of digestive diseases, in the New England Journal of Medicine highlights novel findings from a recent multicenter, double-blind, randomized clinical trial evaluating thalidomide in the treatment of angiodysplasia-related bleeding.
This study showed that thalidomide resulted in a significant decrease in bleeding episodes compared to placebo, likely due to its antiangiogenic properties. Importantly, this study also highlights that the decreased risk of bleeding was observed even after the medication was stopped, suggesting that thalidomide alters these abnormal blood vessels and may act as a disease modifier.
The editorial further puts into perspective the role of thalidomide alongside other treatments suggested for angiodysplasia-related bleeding (e.g., somatostatin analogs such as octreotide), including the consideration of side effects and adherence to treatment.
To learn more, read the editorial “Management of Bleeding Due to Small-Intestinal Angiodysplasias.”
Laine, L. (2023). Management of bleeding due to small-intestinal angiodysplasias. New England Journal of Medicine, 389(18), 1718–1720. https://doi.org/10.1056/nejme2310338