Thalidomide in ankylosing spondylitis.

Despite potential side effects dominated by teratogenicity and peripheral neuropathy, thalidomide has recently been used to treat severe ankylosing spondylitis (AS). Over 50 patients have been treated across several 6-12 month open studies. Altogether 68% of the patients improved and the drop-out rate was 19%. Inhibition of NF-kappaB and/or TNFalpha is a putative mechanism for thalidomide efficacy in AS.