Thalidomide Research Paper

Thalidomide (α- phthalimido-glutarimide) was first marketed in Germany in 1956 as a sedative. In the following few years, it was prescribed in many countries in Europe, Asia, and Australia, to pregnant women in order to alleviate nausea and help them sleep [1]. However, it was banned in 1961 following an epidemic of malformations of the limbs, ears, and of internal organs. The negative effects of thalidomide led to the development of more structured drug regulations and control over drug use and development [1]. Despite its teratogenic effects, thalidomide has diverse pharmacologic properties and therapeutic potential in infectious, autoimmune, and many inflammatory conditions [2]. This paper will outline the current uses of thalidomide with

Moreover, despite its teratogenic effects, there was a renewed interest in its potential to treat many diseases due to its anti-inflammatory and immunomodulating properties [16]. A historically important example is a report of its remarkable effects in the treatment of lesions associated with erythema nodosum leprosum (ENL) [5,6]. Erythema nodosum leprosum is an immune mediated reactional state that complicates lepromatous leprosy. It is characterized by the presence of cutaneous nodules but peripheral organs may also be affected [7]. The treatment of ENL is difficult because of prolonged requirement of high doses of steroids, which do not always control the inflammation associated with the disease. In addition, the immunosuppressive effects of corticosteroids may, per se, pose life-threatening risks for the patients [8]. Treatment with thalidomide provides an effective alternative to steroid therapy, as it shows better long-term control and avoids adverse effects of prolonged steroid therapy, primarily due to its action on TNF-α; thalidomide inhibits TNF-α synthesis by inducing TNF-α mRNA degradation [9, 24]. Most patients feel the benefit within 24-48 h starting at a dose of 25-200mg/d. [4]. As a consequence, in 1998, the Food and Drug Administration (FDA) of the United States approved thalidomide for use in

In one study, there was a reduction in ulcer diameter in 90% of patients treated with thalidomide at an initial oral dose of 400mg/d for 1 week, followed by 200mg/d for 7 weeks [11]. In another study, cachexic patients who received 400mg/d of thalidomide had significant weight gain and/or no progression of wasting [12]. The effect of thalidomide in cachexia may be due to its role in the reduction of cytokines that are mediators of this condition [23]. Although thalidomide has demonstrated an undeniable benefit in the treatment of ENL, malignant tumours, and HIV-linked oral ulcers and wasting syndrome, caution must be taken given the frequent occurrence of side effects, such as teratogenesis, and many CNS