Inhibition of TNF-alpha synthesis with thalidomide for prevention of acute exacerbations and altering the natural history of multiple sclerosis.

Multiple sclerosis (MS) is a common neurological disorder which has a relapsing/remitting course and is presently incurable. A variety of agents have been tried to prevent excerbations and alter the natural history of the disease. Tumor necrosis factor-alpha (TNF-alpha) has been implicated as the most important cytokine in the pathogenesis of MS. There is evidence that thalidomide is an agent which blocks production of TNF-alpha by a mechanism different from other agents. Hence it is hypothesized that using thalidomide as therapy would prevent acute exacerbations of MS as well as alter its natural history.