A pilot study of thalidomide for patients with symptomatic mesenteric panniculitis

Summary Background : Mesenteric panniculitis is a rare condition with no standard therapy. Aim : To assess the safety and efficacy of thalidomide for the treatment of patients with symptomatic mesenteric panniculitis using a newly established clinical disease activity index (Mesenteric Panniculitis Subjective Assessment Score). Methods : In an open‐label pilot study, five patients with symptomatic mesenteric panniculitis received oral thalidomide, 200 mg nightly, for 12 weeks. The primary end‐point was a reduction in the Mesenteric Panniculitis Subjective Assessment Score by ≥ 20% at 12 weeks or complete remission (absence of symptoms). Results : Four (80%) of the five patients responded. The median Mesenteric Panniculitis Subjective Assessment Score at baseline was 39 and at week 12 was 25 (average decrease of 44%). One patient achieved complete remission by week 4, which was sustained. At 12 weeks, three (75%) patients experienced a global response, five (100%) patients had a ≥ 20% (range, 29–98%) decrease in erythrocyte sedimentation rate and three (75%) patients had a ≥ 20% (range, 61–93%) decrease in C‐reactive protein. Abdomino‐pelvic computed tomography scans were unchanged in all five patients. There were no serious adverse events. Conclusions : Thalidomide is safe, well tolerated and efficacious in the treatment of some patients with symptomatic mesenteric panniculitis. Further study is indicated.