The re-emergence of thalidomide: results of a scientific conference.
BACKGROUND
The use of thalidomide during the 1950s resulted in teratogenic effects in thousands of infants. Although thalidomide is currently approved for the treatment of a complication of leprosy, it is commercially available to treat other diseases through a controlled distribution system. This article presents a summary of a scientific conference organized to assess clinical research on thalidomide, its new clinical applications, and the social and ethical implications for its use.


METHODS
Summaries of 10 presentations and two panel discussions were developed from the authors's, oral presentations, conference slides, responses to questions, and supporting literature.


RESULTS
Thalidomide shows promise in treating several diseases, including HIV/AIDS, rheumatoid arthritis, Crohn's disease, and multiple myeloma. The STEPStrade mark (System for Thalidomide Education and Prescribing Safety) Program has been developed by Celgene, the commercial manufacturer of thalidomide, to ensure compliance with prescription and usage protocols. A surveillance system is also in place to monitor and report compliance patterns.


CONCLUSIONS
Despite the tragic past associated with thalidomide, the drug shows promise as a treatment for many clinical disorders. The challenge is to answer lingering questions of risks and benefits through clinical trials and discovery, to monitor participation and compliance with protocols developed to avoid use of the drug during pregnancy, and to continue to search for safer and more effective treatment options.
Neiger
B L
BL
Department of Health Science, Brigham Young University, Provo, Utah 84602-2107, USA. brad_neiger@byu.edu
D000014:Abnormalities, Drug-Induced / Q000209:etiology / Q000517:prevention & control; D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy; D004992:Ethics, Medical; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D011247:Pregnancy; D011358:Product Surveillance, Postmarketing; D013723:Teratogens; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use
D000276:Adjuvants, Immunologic; D019380:Anti-HIV Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000970:Antineoplastic Agents; D013723:Teratogens; D013792:Thalidomide