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 20 th 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Thalidomide Withdrawn!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 Thalidomide was finally withdrawn in 1961 (1962 in some countries).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!