What are IMiDs?

Immunomodulatory drugs or IMiDs are structural and functional analogs of thalidomide and potent modulators of the immune system. The two leading examples of IMiDs are pomalidomide and lenalidomide. Lenalidomide is currently available as a multiple myeloma therapy and both of the drugs are currently undergoing evaluation as potential therapies for other haematological malignancies.

Thalidomide was the first agent to be approved for the treatment of multiple myeloma but its use is associated with significant toxicity, especially in older patients. Thalidomide’s immunomodulatory effects were first realized when it was shown to reduce symptoms in a painful complication of leprosy called erythema nodosum leprosum.

Further research showed that the drug’s effect included inhibition of de novo IgM synthesis, stimulation of T-helper cell production and inhibition of tumor necrosis factor–α. In addition, it showed anti-angiogenic effects, inhibiting the ability of tumors to form new blood vessels to support their growth. This led to starvation of the tumors which eventually killed them.

Studies showed that in relapsing and refractory multiple myeloma, thalidomide could produce response rates that were superior to any other single anti-cancer agents. In new cases of the disease, thalidomide alone and in combination with the steroid dexamethasone produced satisfactory results. As a result, the drug was approved for use in combination with dexamethasone for multiple myeloma in 2006. Examples of maintenance therapies with thalidomide-containing regimens included:

  • Thalidomide, adriamycine and dexamethasone
  • Bortezomib, melphalan, prednisone and thalidomide (VMPT)
  • Melphalan, prednisone and thalidomide (MPT)
  • Vortezomib, thalidomide and dexamethasone (VTD)
  • Thalidomide and dexamethasone (TD)

However, adverse effects were commonly associated with the use of thalidomide and included tiredness, constipation, bloating, fluid retention, rash, venous thromboembolism and peripheral neuropathy.

Lenalidomide and pomalidomide are IMiDs that have enhanced immunomodulatory and anticancer properties over thalidomide as well as fewer side effects. These agents are promising future therapies for several immune cell cancers including multiple myeloma.

Further Reading

Last Updated: Dec 31, 2022

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

Citations

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Mandal, Ananya. (2022, December 31). What are IMiDs?. News-Medical. Retrieved on November 21, 2024 from https://www.news-medical.net/health/What-are-IMiDs.aspx.

  • MLA

    Mandal, Ananya. "What are IMiDs?". News-Medical. 21 November 2024. <https://www.news-medical.net/health/What-are-IMiDs.aspx>.

  • Chicago

    Mandal, Ananya. "What are IMiDs?". News-Medical. https://www.news-medical.net/health/What-are-IMiDs.aspx. (accessed November 21, 2024).

  • Harvard

    Mandal, Ananya. 2022. What are IMiDs?. News-Medical, viewed 21 November 2024, https://www.news-medical.net/health/What-are-IMiDs.aspx.

Comments

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
Post

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
How a ketogenic diet could reduce autoimmune disease severity through host-microbiome interactions