Thalidomide for Corticosteroid-Dependent IRIS?

Three patients showed rapid clinical remission and discontinued corticosteroids without relapse, but convincing evidence of thalidomide's efficacy for this condition requires additional data.

Immune reconstitution inflammatory syndrome (IRIS) can complicate the initiation of antiretroviral therapy (ART) in patients with active opportunistic infections (OIs). Corticosteroids are the mainstay of therapy for severe IRIS and have been shown to hasten improvement of symptoms and shorten hospitalization in tuberculosis-associated IRIS (TB-IRIS; JW AIDS Clin Care Sep 27 2010). However, some patients — most often those with cryptococcal IRIS — develop relapsing or refractory IRIS that is steroid dependent.

Researchers in France report the effects of thalidomide (100 mg/day) and aspirin in three HIV-infected patients with steroid-dependent IRIS (2 with cryptococcal IRIS and 1 with TB-IRIS). These patients initiated or optimized ART within…

Reviewing Author

Philip Grant, MD

Thalidomide for Corticosteroid-Dependent IRIS?

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Reviewing Author