Madame Geoffrin's 21st Century Drug Salon

Madame Geoffrin's 18th Century salons, as a gathering place for public discourse, are regarded as Renaissance versions of online social networking. Such collective knowledge and discussion has found numerous creative uses, including fresh approaches to improve public health.

In this case, NIH scientists are searching for new uses of old drugs - those already approved by the FDA for a particular illness by mining large databases and sharing their data, a 21st century version of Madame Geoffrin's salons - speeding up the process of drug discovery considerably. Physicians have had the freedom to use approved drugs for treating illnesses other than those for which it was originally approved - so called "off label" use. However, until recently there has been little systematic study of understanding both unwanted side effects and unexpected beneficial side effects.

Early efforts have begun to bear fruit. Here are a few recent examples, from the June 24 issue of Science:

This is quite extraordinary. Imagine a treatment for bipolar disorder using a breast cancer drug. There are many other examples, such as:

• Closantel, a drug that has been used to treat cattle and sheep, was found to affect several stages of the river blindness-causing parasite and its molting.
• Recently, MIT researchers have reported that a common antibiotic used for the prevention of poultry disease shows promise as an effective cancer treatment.
• A group at the Johns Hopkins University Bloomberg School of Public Health found that an over the counter antihistamine shows potential for the treatment of resistant malaria.
• An acne medication, minocycline, has been found to inhibit the HIV virus.

Of course, off label use of these medications must be used with caution. Since they are FDA approved, each drug has already met careful scrutiny with regards to overall safety. With systematic study on new uses, we are likely to uncover many more benefits than are currently appreciated. Yes, side effects will always be a factor, but it's all about balancing risk vs. benefits.

Using the "wisdom of the crowd" to find cures to our ills is something of which I am certain Madame Geoffrin would approve!