A short history of dapsone, or an alternative model of drug development.
From 1936 until 1996, the drug dapsone treated a diverse array of diseases, including tuberculosis, leprosy, malaria, and AIDS-related pneumonia. This article explores how dapsone transformed from a cure for one disease into a treatment for a totally different malady. This process of reinvention in the clinic represents an alternative model of drug development that the historical literature, focused on success in the laboratory, has largely ignored. The core of the paper discusses the reinvention of dapsone as an antimalarial in the Vietnam War through trials led by Robert J. T. Joy, a physician and military officer. As a case study, it offers a fresh perspective on the clinic-as-laboratory approach that other scholars have addressed in a civilian context. Viewing the randomized clinical trial (RCT) through a military prism will demonstrate how a combat environment combined with the regimentation of the armed forces affected the standard methodology of the RCT.
Barr
Justin
J
History of Science and Medicine Department, Yale University, 333 Cedar Street, SHM L132, New Haven, Connecticut 06520, USA. justin.barr@yale.edu
D000962:Antimalarials / Q000266:history*; D003622:Dapsone / Q000031:analogs & derivatives / Q000266:history*; D004345:Drug Industry / Q000266:history; D049673:History, 20th Century; D006801:Humans; D007917:Leprostatic Agents / Q000266:history; D007918:Leprosy / Q000266:history; D008288:Malaria / Q000453:epidemiology; D008887:Military Medicine / Q000266:history; D008889:Military Personnel / Q000706:statistics & numerical data; D011020:Pneumonia, Pneumocystis / Q000266:history; D016032:Randomized Controlled Trials as Topic / Q000266:history; D047829:Vietnam Conflict; D010128:p-Aminoazobenzene / Q000031:analogs & derivatives / Q000266:history; D044482:Benzeneacetamides
D000962:Antimalarials; D003622:Dapsone; D007917:Leprostatic Agents; D010128:p-Aminoazobenzene; C037441:glucosulfone; C003359:sulfamidochrysoidine; D044482:Benzeneacetamides