Healthy Skepticism Library item: 9887

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Brocvielle H, Muret P, Plenat E, Kantelip JP, Humbert P.
Management of a patient receiving thalidomide
Presse Med. 2003 Dec 20; 32:(40):1894-8
http://www.masson.fr/masson/portal/bookmark?Global=1&Page=18&MenuIdSelected=106&MenuItemSelected=0&MenuSupportSelected=0&CodeProduct4=100&CodeRevue4=PM&Path=REVUE/PM/2003/32/40/ARTICLE1110875240.xml&Locations=

Abstract:

The use of a drug with a temporary marketing autorisation Thalidomaide is currently available in France for nominative or cohort use with a temporary marketing autrhorisation (TMA). It is only prescribed and delivered in hospital settings, Six official indications Its current indications are principally lepromatous nodular erythema, severe aphtosis, Jessner-Kanoff’s cutaneous lymphocyte infiltration, discoid lupus erythematosis, chronic graft-versus-host reactions, and relapsed and or refractory multiple myeloma (after the failure of standard therapies). In the majority of cases, thalidomide is a last resort treatment of rare pathologies. On withdrawal, it is responsible for more or less long-term reccurrences of the disease that require its re-introduction. Surveillance is crucial. The side effects induced by thalidomide must never be forgotten, notably its teratogenic effects and its often irreversible neurotoxicity. The latter limit the long-term use of thalidomide and imply strict rules for its prescription and surveillance (efficient contraception, clinical neurological examinations, electroneurophysiological controls).

Keywords:
Abnormalities, Drug-Induced/prevention & control* Adult Female France Humans Immunosuppressive Agents/adverse effects* Immunosuppressive Agents/therapeutic use* Male Monitoring, Physiologic Nervous System Diseases/chemically induced Thalidomide/adverse effects* Thalidomide/therapeutic use*

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909