LAUSR

on the literature on Best Practice (BMJ), Dynamed and UpToDate, being used the DeCS and MeSH indexed terms: “Lupus Erythematosus, Cutaneous” and “Thalidomide”. Results: According to the evidence on the BMJ, Thalidomide is indicated as a third-line treatment in systemic erythematosus lupus (LES) patients in the following situations: all patients for cutaneous erythematosus lupus (LEC) who do not respond to other treatments; including discoid erythematosus lupus (LED) lesions indicated in once a day doses of oral 50-200mg. On Dynamed, a update (2013) indicates the use of thalidomide in improving the recurrent (refractory) LEC but it was found high neurotoxicity. The UpToDate evidence synthesis reports that when one or more of first line agents is not successful, more aggressive therapy to reduce remission of the disease should be considered. Still, thalidomide is highly efficacious for LEC, but has potential for serious adverse effects, including teratogenicity and a relatively high risk of peripheral neuropathy. Thalidomide has a rapid onset of action, usually with response within the first month of treatment. This should be initiated at 50mg to 100mg daily doses, and reduced to the minimal effective dose after clinical improvement. ConClusions: Thalidomide can be used for the treatment of patients with LES, especially refractory and who did not respond to first-line treatments. Potential adverse effects of thalidomide make it more useful as short-term remission inducing agent and as maintenance treatment, concurrently with conventional medications or other systemic medicinal products for the refractory LEC.