Transcript Thalidomide

Thalidomide
The Phoenix Drug
History
Medicines are poisonous – indeed, up to
a century ago the medicines given were
more likely to kill than cure the patient!
E.g. arsenic for syphilis, strychnine for a
failing heart etc.
History
This all started to change with the
discovery of sulphonamides and
penicillins in the early 20th Century
Medicines could safely cure the patient
– great advances began to be made in
therapy.
Thalidomide
Synthesised in early
1950’s by CIBA in
Switzerland as a potential
new medicine but they
could not find any use for
it.
Development
discontinued in 1953.
Chemie Gruenenthal
Taken up in 1954 by Chemie
Gruenenthal and developed first as an
anti-convulsant (ineffective!), then as
an anti-histamine (ineffective!) and
finally as sedative.
Found to be particularly useful to treat
morning sickness.
Side Effects of Thalidomide
Started to be
noticed in late
1950’s but took time
to associate effects
with thalidomide
Manufacturers at
this time were
promoting the
medicine as safe.
Side Effects of Thalidomide
Severe limb
abnormalities in
children of mothers
taking thalidomide
Also deafness,
blindness, cleft
palate, internal
abnormalities
Thalidomide Withdrawn!
Pioneering work by Frances Kelsey in
the USA finally convinced the
manufacturers and the World of the link
between thalidomide and the horrific
birth defects.
Thalidomide was finally withdrawn in
1961 (1962 in some countries).
Thalidomide’s Legacy
1000’s of people (now adults) with limb
abnormalities (their children are OK)
Directly led to extensive safety testing
of drugs before release on to market
(FDA, CSM) – thalidomide never tested!
Thalidomide became a research tool –
some very useful effects
New research areas
Thalidomide has been shown to be of
use in a variety of conditions:
- it inhibits angiogenesis (development
of new blood vessels) – use in cancer
- it is anti-inflammatory
- it stimulates the immune system –
tuberculosis in AIDS patients
Thalidomide rises from the
ashes!
In 1998 thalidomide was licensed for
treatment of one form of leprosy
- ENL (Erythema Nodosum Laprosum)
- amazingly effective and successful
- WHO showed 99% of patients
improved significantly
- hailed as a wonder drug (again!)
Thalidomide rises from the
ashes!
However!