THE USE OF A DRUG WITH A TEMPORARY MARKETING AUTHORISATION: Thalidomide is currently available in France for nominative or cohort use with a temporary marketing authorisation (TMA). It is only prescribed and delivered in hospital settings. SIX OFFICIAL INDICATIONS: Its current indications are principally lepromatous nodular erythema, severe aphtosis, Jessner-Kanoff's cutaneous lymphocyte infiltration, discoid lupus erythematosis, chronic graft-versus-host reactions, and relapsed and or refractory multiple myeloma (after the failure of standard therapies). In the majority of cases, thalidomide is a last resort treatment of rare pathologies. On withdrawal, it is responsible for more or less long-term recurrences of the disease that require its re-introduction. SURVEILLANCE IS CRUCIAL: The side effects induced by thalidomide must never be forgotten, notably its teratogenic effects and its often irreversible neurotoxicity. The latter limit the long-term use of thalidomide and imply strict rules for its prescription and surveillance (efficient contraception, clinical neurological examinations, electroneurophysiological controls).
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