Thalidomide

Red

Brand Name(s):Thalidomide Pharmion

Indication:Multiple Myeloma (untreated)

Rationale:1,2,3

Considered:Mar-07

Review Date:Feb-21

Comments:
NG35
Myeloma: diagnosis and management
Full document available at:http://www.nice.org.uk/guidance/ng35/resources/myeloma-diagnosis-and-management-1837394042821
Feb 2016
Drug Safety Update
Thalidomide: reduced starting dose in patients older than age 75 years
full information available at:https://www.gov.uk/drug-safety-update/thalidomide-reduced-starting-dose-in-patients-older-than-age-75-years
December 2015

Drug Safety Update
Patients treated with thalidomide have an increased risk of haematological second primary malignancies (acute myeloid leukaemia and myelodysplastic syndromes). Healthcare professionals should consider this risk when deciding whether to treat patients with thalidomide, and should monitor for the occurrence of these conditions

Advice for healthcare professionals:
Before starting thalidomide treatment in combination with melphalan and prednisone, take into account both the likely benefit expected from thalidomide and the risk of acute myeloid leukaemia and myelodysplastic syndromes
Carefully evaluate patients before and during treatment using standard cancer screening and provide appropriate treatment
Volume 6, Issue 10 May 2013
…………………………
NICE Guidance
Thalidomide in combination with an alkylating agent and a corticosteroid is recommended as an option for the first-line treatment of multiple myeloma in people for whom high-dose chemotherapy with stem cell transplantation is
considered inappropriate.

NICE TA 228 Bortezomib and thalidomide for the first-line treatment of multiple myeloma July 2011
…………………………
Advice for healthcare professionals:
* Patients treated with thalidomide have an increased risk of arterial.thromboembolism, including myocardial infarction and cerebrovascular events, in htm addition to the established risk of venous thromboembolism
* Action should be taken to minimise all modifiable risk factors for thromboembolic events (eg, smoking, hypertension, and hyperlipidaemia)
* Healthcare professionals should consider venous and arterial thrombotic risk and administer antithrombotic prophylaxis for at least the first 5 months in patients commencing thalidomide
Article citation: Drug Safety Update July 2011 vol 4, issue 12: A1.