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The Return of Thalidomide

Its tragic history can't be forgotten

By

Updated April 26, 2003

A dark history
Most people who recognize the name “thalidomide” associate it with “birth defects.” Introduced in the late 1950s, this drug was marketed as a sleeping aid, sedative, morning-sickness remedy and anti-nausea medication in at least 46 countries. Among the many people who took thalidomide were pregnant women (and women who did not yet know they were pregnant). It was discovered then that thalidomide caused severe birth defects. In many cases, babies affected by thalidomide did not survive; those who did often had shortened arms or legs (phocomelia), deafness, blindness or gastrointestinal anomalies.

It has been estimated that 10,000 or more babies were affected by thalidomide; many more died or were born with defects not recognized as being caused by the drug. The drug also caused irreversible nerve damage in many adults who took it.

In many countries, families affected by thalidomide joined class action lawsuits against the companies who manufactured or distributed the drug. In most cases, lump-sum or annual settlements were negotiated. In other countries, such as the United States and Canada, individual lawsuits brought about settlement payments.

The return of thalidomide
The United Kingdom has allowed the use of thalidomide in special cases since 1968, and implemented a guideline for its use and prescription in 1994. In 1998 the U.S. FDA approved the use of thalidomide for treatment of erythema nodosum leprosum (ENL), a painful skin condition in leprosy.

Thalidomide has been researched as a possible treatment for many other disorders, including:

  • multiple myeloma (blood cancer)
  • multiple sclerosis
  • pyoderma gangrenosum
  • ulcerative bowel disease or Crohn’s disease
  • cutaneous (discoid) and systemic lupus erythematosus
  • Behcet’s syndrome
  • aphthous ulcers
  • Kaposi’s sarcoma
  • myelofibrosis with myeloid metaplasia (MMM)
  • kidney, brain, and breast cancers
  • complex regional pain syndrome

For some of these disorders, thalidomide has provided treatment not possible with any other existing medication. The manufacturer of thalidomide, Celgene, has set up a program which includes educating people about to take the drug, requiring them, their doctor, and pharmacist to register with the company, and requiring women to have pregnancy testing before, during, and after being prescribed the drug.

A strong warning
The Thalidomide Victims Association of Canada, among others, has made it clear that they “will never accept a world with thalidomide in it.” Many victims feel that it is only a matter of time before another “thalidomide baby” is born. However, many are hopeful that drugs similar to but better than thalidomide will be developed, ones without the tragic effects that have been the legacy of thalidomide.

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