02205nas a2200349   4500000000100000008004100001260001300042653001500055653001000070653001100080653002300091653002100114653003000135653001100165653001100176653002300187653000900210653001600219653001800235653001600253653001700269653001600286100002000302700001300322245011900335856010600454300001100560490000700571050002100578520124200599022001401841       2013                            d  c2013 Nov10aAdolescent10aAdult10aBrazil10aDrug Prescriptions10aDrug Utilization10aDrug and Narcotic Control10aFemale10aHumans10aLeprostatic Agents10aMale10aMiddle Aged10aOff-Label Use10aThalidomide10aTime Factors10aYoung Adult1 aPaumgartten FJR1 aSouza NR00aClinical use and control of the dispensing of thalidomide in Brasilia-Federal District, Brazil, from 2001 to 2012.  uhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232013001100029&lng=en&nrm=iso&tlng=en  a3401-80 v18  aPAUMGARTTEN 20133 a<p>The use of thalidomide was never discontinued in Brazil where it is prescribed for leprosy type 2 reaction. Babies with birth defects compatible with the thalidomide embryopathy phenotype were born after 1965, an indication that control on drug dispensing and use failed in the country. The article reports data on thalidomide dispensing and clinical uses in the Federal District in 2011/12, when new rules were put into effect, and data on drug dispensing and use obtained ten years earlier. It was found that the number of patients making use of thalidomide declined from 819 in 2001 to 369 in 2011/12. Leprosy accounted for over 70% of prescriptions in both time periods analyzed in this study. In the same time interval, however, use for lupus erythematosus decreased from 13.7 to 4.9%, while that for multiple myeloma increased from 2.9 to 20.3% of all prescriptions. Thalidomide prescription for the remaining approved indications was far less frequent, and so was the use for off label indications that accounted for <1% of prescriptions in 2001 and 2011/12. Registration of prescribing doctors, patients and dispensing units at the state department of health, apparently rendered this control more effective and reliable. </p>  a1678-4561