P945 CLINICAL OUTCOME OF GASTRIC VARICES IN PATIENTS WITH PORTAL HYPERTENSION WITH OR WITHOUT CIRRHOSIS WITHOUT A PREVIOUS HISTORY OF BLEEDING

Abstract

Background and Aims: Gastrointestinal vascular anomalies can cause chronic anaemia, a clinical challenge in terms of endoscopic therapy, transfusion and hospital admissions. Evidence suggests Thalidomide as a therapeutic option for such patients. We aim to determine the efficacy and side-effect profile of Thalidomide in patients with gastrointestinal vascular anomalies. Methods: A retrospective case-note review 12-months preand post-Thalidomide therapy. Results: Patients on Thalidomide due to failed standard therapy between the years 2004 and 2013 were included. 17 patients comprising 7 women and 10 men with a median age of 68.5 years (range 48–87 years) were identified. Endoscopic diagnoses were; portal hypertensive gastropathy (PHG) (n =5), Gastric Antral Vascular Ectasia (GAVE) (n = 9), PHG/GAVE (n =4), upper gastrointestinal vascular malformation (GIVM) (n =5) and lower GIVM (n=2). 11 patients continued treatment beyond 3 months and 5 out of 11 took Thalidomide for atleast 12 months. There was reduction in transfusion frequency by 65% (p < 0.05), number of red cell concentrate units by 71% (p < 0.05), number of OGDs by 81% (p < 0.05), number of argon treatments by 75% (p < 0.05), and number of hospital admissions by 71% (p < 0.05) for the 11 patients. No statistically significant improvement was seen in patients who received less than 3 months of therapy. 27% developed side effects (3/11). The side effects reported were peripheral neuropathy, fatigue and pancytopenia, which lead to cessation of therapy. Conclusions: Thalidomide has a role in the management of gastrointestinal vascular lesions resistant to conventional treatment, drug side effects are common and require monitoring. P945 CLINICAL OUTCOME OF GASTRIC VARICES IN PATIENTS WITH PORTAL HYPERTENSION WITH OR WITHOUT CIRRHOSIS WITHOUT A PREVIOUS HISTORY OF BLEEDING E. Ahn, P. Kortan, G. May, N. Marcon, G. Kandel, Y.I. Kim, S. Grover, M. Cirocco, F. Wong. Division of Gastroenterology, Toronto General Hospital & University of Toronto, Division of Gastroenterology, St. Michael’s Hospital, Toronto, ON, Canada E-mail: eric.ahn@mail.utoronto.ca