Thalidomide is used as a first-line treatment in multiple myeloma in combination with dexamethasone or with melphalan and prednisone, to treat acute episodes of erythema nodosum leprosum, and for maintenance therapy. The bacterium that causes tuberculosis (TB) is related to leprosy. Thalidomide may be helpful in some cases where standard TB drugs and corticosteroids are not sufficient to resolve severe inflammation in the brain.
Recently, thalidomide has re-emerged as an antiangiogenic, anti-inflammatory, and anti-fibrotic agent. Through decreasing the synthesis of TNF-alpha, thalidomide has been used as a treatment for multiple inflammatory diseases, such as Crohns disease and Behcets disease. In addition, preclinical studies proved that thalidomide was effective in treating H1N1-infected mice by reducing infiltration of inflammatory cells and the production of pro-inflammatory cytokines. Current studies are focusing on its immunomodulatory effects that could lessen lung injury caused by excessive immune response to SARS-CoV-2.
Kwon HY, Han YJ, Im JH, Baek JH, Lee JS. Two cases of immune reconstitution inflammatory syndrome in HIV patients treated with thalidomide. Int J STD AIDS. 2019 Oct;30(11):1131-1135. doi: 10.1177/0956462419847297. Epub 2019 Sep 19.