An interesting paper from a specialist centre in the Netherlands regarding the use of thalidomide in HHT patients. The St Antonius hospital has 1238 patients with HHT and 1% of these use thalidomide. The aim was to assess the benefits, objectively and subjectively and also the side-effects. Five years of records yielded 12 eligible patients taking 50-100mg of thalidomide daily for this cohort study, which has been designed with a view to a larger trial. Data was collected by questionnaire with patients asked general health questions to detail the severity of their HHT before, three months into and currently or just before stopping use. Data was also collected on duration and frequency of nose bleeds and also on number of blood transfusions. Most patients seem to have benefitted although more than half stopped treatment due to side effects, in particular, neuropathy, pain and oedema, skin reactions and general malaise. This paper highlights that thalidomide is only beneficial to a certain cohort of patients with this disease and probably should only be commenced in specialist centres with the necessary expertise to continue the assessment and supervision of these patients. Knowledge of the side-effects appears important also, since this would seem to be a major factor with patients.

Follow-up of Thalidomide treatment in patients with Hereditary Haemorrhagic Telangiectasia.
Hosman AE, Westermann CJJ, Snijder R , et al.
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Suki Ahluwalia

Cairns Hospital / James Cook University, Queensland, Australia.

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