How The World’s Most Maligned Medication Found A Purpose

Sep 30, 2022

Amongst the biggest developments in the history of medication include the synthesis of aspirin, the discovery of penicillin and the aftermath of the thalidomide disaster.

The modern world of pharmacy digital marketing is very highly regulated; prescription medications cannot be marketed directly to customers and medical claims must have robust evidence to stay within the guidelines of the Advertising Standards Agency.

The genesis of this modern definition of medicine can be traced back to the Medicines Act 1968, and the reason for this was the result of irresponsible medical marketing that caused the death, deformity and serious illness of over 10,000 children.

This is the story of that disaster, the greatest man-made medical catastrophe in history up until that point, the aftermath that changed, albeit at far too great a cost, the medical world as we know it, as well as how thalidomide was repositioned to treat conditions such as leprosy and certain types of cancer.

Dawn Of A Disaster

Thalidomide was first synthesised in 1952 by Chemical Industry Basel (CIBA) initially for use as an animal-grade sedative and tranquilliser. However, it was found to be ineffective for this and was abandoned in 1953.

A year later, Chemie Grünenthal acquired the compound and found a by-product that was a particularly effective antiemetic that relieved nausea and conditions that induced vomiting, and at that point, it was considered to be particularly effective against morning sickness, albeit never tested on pregnant women.

Specifically, they only tested for harm to the mother rather than potential harm to the foetus, with doctors at the time not being aware as we are today that drugs pass across the placental barrier.

In 1958, thalidomide under the brand name Distaval was launched as a morning sickness remedy in the UK by The Distillers Company and as Contergan in other countries.

By 1961, over 2000 babies were reported to have birth defects in the UK alone and up to 20,000 worldwide, leading to the drug being taken off store shelves.

The Aftermath

Of those 2000 babies that were born alongside an unknown number of miscarriages, less than half survived their first few months, and as of 2010, 466 have survived.

After these concerns were found, many countries including the UK withdrew the medication, although Canada sold it until 1962 and it was available in Spain until the 1980s.

The Sunday Times ran a campaign for years to provide compensation to the people affected by thalidomide, with a compensation package of £28m being paid out alongside the funding of several trusts to pay for life-long medical treatment in 1968.

The Repositioning

After thalidomide was strictly controlled and effectively banned for most forms of use, researchers and experimental doctors explored whether it could be used to help treat other conditions.

The first was Jacob Sheskin, an Israeli doctor who was the first to find that thalidomide could be used to treat leprosy, particularly the skin condition erythema nodosum leprosum. After finding a way around the drug’s ban, the treatment was relatively successful.

The patient slept comfortable and could get out of bed without help, leading to clinical trials and eventual approval by Brazil’s medical board and the US FDA, albeit with exceptionally strict conditions, particularly for women who take thalidomide.

It is not the preferred treatment according to the World Health Organisation, who noted that clofazimine is a more effective leprosy medication, but it showcases its potential as a second-line treatment.

As well as this, the FDA approved a combination of thalidomide and dexamethasone in 2006 for the treatment of multiple myeloma, a cancer of plasma cells.