Thalidomide returns: scandal-hit drug is now used across NHS

 

Thalidomide, the cause of the biggest medical scandal of the last century, is today recommended for use across the NHS.

It is the final rehabilitation for a drug that once struck terror into patients when it was prescribed to pregnant women as a treatment for morning sickness in the late 1950s and early 1960s. It turned out to cause birth defects in the foetus and about 10,000 babies were born around the world with stunted arms or legs or, in some cases, no limbs at all.

Thalidomide was withdrawn from sale in 1961 and the scandal led to a review of the marketing, testing and regulating of drugs, culminating in the Medicines Act, 1968.

Now, 50 years later, the National Institute for Clinical Excellence has recommended thalidomide for multiple myeloma, a cancer of the bone marrow. The decision marks a watershed in the drug's slow return to respectability. For years it was shunned, but in the 1990s it was shown to be effective in the treatment of leprosy. Further research suggested the mechanism by which it caused birth deformities, through limiting the blood supply to the foetus's limbs, might be harnessed as a treatment for cancer, by inhibiting the growth of blood vessels that feed tumours.

In Britain, thalidomide has been used to treat brain cancer, kidney cancer and Kaposi's sarcoma, a cancer involving the blood vessels of the skin.

Its most potent effects were shown against multiple myeloma, an incurable disease where the aim of treatment is to alleviate symptoms and minimise side effects.Its precise mechanism of action is unknown but it is thought to inhibit the growth and survival of myeloma cells and has an anti-inflammatory action.

The drug costs £2,100 per treatment cycle and is estimated to be suitable for 2,000 patients with multiple myeloma a year.

Thalidomide is prescribed in Brazil, where there are a large number of leprosy patients, but children are still being born today in South America with limb defects because of ignorance of its effects in pregnancy.

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