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Thalidomide Still Use Today !
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Anyone else surprised that Thalidomide is still being dispensed ?
It appears to be used in Brazil to combat Leprosy.
Anyone else surprised that Thalidomide is still being dispensed ?
It appears to be used in Brazil to combat Leprosy.
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Sqad...I looked up teratogenic but for those that haven't ! :::
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mikey....not my field, but antibiotics (medium term and sometimes long term) with steroids to suppress the swelling and pain is the standard treatment.
The benefits? to whom? the patient or the supplier.
The only advantage that i can see of thalidomide is that it is cheaper than the alternative and the teratogenic affects only apply to pregnant women.
The benefits? to whom? the patient or the supplier.
The only advantage that i can see of thalidomide is that it is cheaper than the alternative and the teratogenic affects only apply to pregnant women.
A couple of people called & I rushed my post.
What I meant was, you appear to be arguing that it shouldn't be used because the wrong people 'might' use it. And I'm saying you could say that about any drug.
Of course, I realise with your political bias you see it as a capitalist conspiracy & nothing will dissuade you. So I'll leave you to it.
What I meant was, you appear to be arguing that it shouldn't be used because the wrong people 'might' use it. And I'm saying you could say that about any drug.
Of course, I realise with your political bias you see it as a capitalist conspiracy & nothing will dissuade you. So I'll leave you to it.
The scandal about Thalidomide was the poor or absent clinical trials that were performed, when it was introduced as a kind of "wonder drug" back in the 1950s. And indeed, it does have some very useful and valuable effects.
As already mentioned, the real danger of thalidomide is that it is teratogenic; Leading to those lasting and horrifying images of "thalidomide babies".
But despite its obvious dangers for pregnant women, Thalidomide remains a valuable treatment option for certain types of diseases; Multiple Myeloma, Breast Cancer and some others, ironically in part because it has anti-angiogenic properties, very valuable in attacking the rate of growth of cancers. It is also an effective anti-pyretic, anti-inflammatory and anti- emetic drug. Its anti-emetic qualities were the reason it was prescribed to pregnant women, to combat morning sickness.
Were it not for its horrible teratogenic qualities, it could indeed be considered a wonder drug.
With respect to its use in Brazil, it has a specific use in the treatment of one of the more common complications of leprosy, the deposition of immune complexes in nodules under the skin, which are very debilitating and painful. other drug treatments - prednisolone, a steroid, or clofazime, have only a limited benefit in the treatment of such recurrent chronic complications and prednisolone has side effect and safety issues if prescribed for too long or at a relatively high dose. These are powerful drugs we are talking about.
Thalidomide outperforms them both - there several high quality papers attesting to this - when it comes to managing this particular complication.It is better tolerated, has less side effects, and is cheaper - all very important considerations when treating large numbers of affected patients in a developing country.More research is still needed, especially into direct comparisons of treatment - thalidomide vs corticosteroids -but right now, thalidomide remains an important tool for treating this complication..
Tight controls are in place - it has to be presribed by a physician, for instance, and all the packs carry both written and visual warnings against its use in pregnant women. Despite this, it is likely that there are some "thalidomide babies" born each year, and that is tragic, a failure of the control system - but that is not sufficient reason not to use the drug for all those patients who gain enormous benefits from it.
The WHO recommendation sounds definitive - but it is at odds with the recommendations of their own expert committee who acknowledged the value of thalidomide in the treatment of this specific complication.
Thalidomide is licenced by the FDA in the US for the treatment of leprosy and cancer, by Australia for use in the treatment of ENL in leprosy and for use in the treatment of cancer, is available on a named patient basis in the UK for leprosy treatment and cancer treatment, and elsewhere around the globe too, including the European Medicines Regulatory Body.
A very good paper was written about this back in 2007 by authors based at the London School of Hygiene and Tropical Medicine, which evaluated the risks and the alternatives, and concluded thalidomide had a place. I have included a link to the paper if you are interested.
http://
As already mentioned, the real danger of thalidomide is that it is teratogenic; Leading to those lasting and horrifying images of "thalidomide babies".
But despite its obvious dangers for pregnant women, Thalidomide remains a valuable treatment option for certain types of diseases; Multiple Myeloma, Breast Cancer and some others, ironically in part because it has anti-angiogenic properties, very valuable in attacking the rate of growth of cancers. It is also an effective anti-pyretic, anti-inflammatory and anti- emetic drug. Its anti-emetic qualities were the reason it was prescribed to pregnant women, to combat morning sickness.
Were it not for its horrible teratogenic qualities, it could indeed be considered a wonder drug.
With respect to its use in Brazil, it has a specific use in the treatment of one of the more common complications of leprosy, the deposition of immune complexes in nodules under the skin, which are very debilitating and painful. other drug treatments - prednisolone, a steroid, or clofazime, have only a limited benefit in the treatment of such recurrent chronic complications and prednisolone has side effect and safety issues if prescribed for too long or at a relatively high dose. These are powerful drugs we are talking about.
Thalidomide outperforms them both - there several high quality papers attesting to this - when it comes to managing this particular complication.It is better tolerated, has less side effects, and is cheaper - all very important considerations when treating large numbers of affected patients in a developing country.More research is still needed, especially into direct comparisons of treatment - thalidomide vs corticosteroids -but right now, thalidomide remains an important tool for treating this complication..
Tight controls are in place - it has to be presribed by a physician, for instance, and all the packs carry both written and visual warnings against its use in pregnant women. Despite this, it is likely that there are some "thalidomide babies" born each year, and that is tragic, a failure of the control system - but that is not sufficient reason not to use the drug for all those patients who gain enormous benefits from it.
The WHO recommendation sounds definitive - but it is at odds with the recommendations of their own expert committee who acknowledged the value of thalidomide in the treatment of this specific complication.
Thalidomide is licenced by the FDA in the US for the treatment of leprosy and cancer, by Australia for use in the treatment of ENL in leprosy and for use in the treatment of cancer, is available on a named patient basis in the UK for leprosy treatment and cancer treatment, and elsewhere around the globe too, including the European Medicines Regulatory Body.
A very good paper was written about this back in 2007 by authors based at the London School of Hygiene and Tropical Medicine, which evaluated the risks and the alternatives, and concluded thalidomide had a place. I have included a link to the paper if you are interested.
http://
This problem has been around for decades. The affected babies are very few, and the authorities do their utmost to see that fertile women do not receive it, but small numbers still happen. However, I have read in the scientific press that Thalidomide is chiral - that is "left-handed" and "right-handed" and that only one of these forms causes defects. It may be possible to isolate the non-dangerous from the dangerous form, but it could be very difficult and/or very expensive to do.
Atalanta - Thats true. Its the laevo version that is teratogenic. Problem is, Thalidomide is a chiral molecule, and forms a racemic mixture - That is, an equal proportion of both laevo and dextro enantiomers.
And even were you to give a purified dose of the R-enantiomer of Thalidomide, it racemises in vivo - it spontaneously equilibrates to both laevo and dextro forms.
And even were you to give a purified dose of the R-enantiomer of Thalidomide, it racemises in vivo - it spontaneously equilibrates to both laevo and dextro forms.
Shari..the problem is that Thalidomide has been shunned all over the world for years, until Brazil started to use it again. Its used to treat Leprosy in the main and this is a disease of the poor. Its impossible to stop the wrong people from using it and this is why badly deformed babies are being born again. If it could be restricted to men and boys, then everything would be OK but if that was easy, then over a 100 babies with deformities wouldn't have been born. Countless others have been born dead, or lost in mid-pregnancy.
It would seem to me that its far too risky a drug to use, when there are other much less damaging drugs that can be used instead. The drug companies are almost certainly jumping up and down with joy that they can make money again out of something so risky that if were being developed today, no country on the planet would allow it to be used.
It would seem to me that its far too risky a drug to use, when there are other much less damaging drugs that can be used instead. The drug companies are almost certainly jumping up and down with joy that they can make money again out of something so risky that if were being developed today, no country on the planet would allow it to be used.
I'm sorry Mike, I strongly disagree. I am a fertile girl ( as far as I know) and if Thalidomide was the most suitable drug to treat my condition I would happily use it. Are you suggesting you withdraw it's use for women? so you would say I'll treat your husband's leprosy but not yours? That's crazy when so many other commonly used drugs cause birth defects. It's almost as if Thalidomide is a bogey man that the public feel happy fearing when in fact they are surrounded by simi9lar monsters under the right circumstances.
Another point is that Thalidomide wasn't "shunned over for years" until just recently. It was merely removed from the market, but studies and use have continued since. The first use to combat leprosy was in 1964, followed by clinical trials and then continued use in Brazil since 1965.
In response to Sharingan -- suitability includes assessment of risk, and if there were a risk that you might become (or already were) pregnant then I highly doubt that Thalidomide would be prescribed. That is ultimately a judgement for doctor and patient, of course, as and when the case arises. In principle I agree with you, that Thalidomide shouldn't be withheld just from women regardless of the circumstances.
In response to Sharingan -- suitability includes assessment of risk, and if there were a risk that you might become (or already were) pregnant then I highly doubt that Thalidomide would be prescribed. That is ultimately a judgement for doctor and patient, of course, as and when the case arises. In principle I agree with you, that Thalidomide shouldn't be withheld just from women regardless of the circumstances.
Exactly jim, it's for the individual Doctors to decide with their patients not for the public to get all worked up about. Point of interest there is quite a common acne drug often prescribed to girls which causes birth defects and my mother had to ensure she didn't become pregnant when takeing something for her PPP as well. It's really quite common. ;-)
Lazygun...if you are referring to your 12:46 post than yes I did. I didn't understand most of it though. Your post of 12;26 was very interesting and thanks. My point is with this drug is that its use can only be controlled up to a point. It can still get into the hands of women, who may be pregnant and not be aware that they are. This is presumably where the deformed children and some at least of the still births have come from. Brazil is largely a third-world country and consequently its health care system must be considerably more chaotic than dear old Blighty. I still maintain that a large avoidable risk is being taken with Thalidomide.
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