Table 1 Differences between thalidomide, lenalidomide and pomalidomide

Empirical Formula

C₁₃H₁₀N₂O₄

C₁₃H₁₃N₃O₃

C₁₃H₁₁N₃O₄

Molecular weight

258.2

259.3

273.2

Chemical Structural

Thalidomide has two oxo groups in Phthaloyl ring

Lenalidomide has amino group at 4th position and single oxo group in Phthaloyl ring

Pomalidomide has amino group at 4th position and two oxo groups in Phthaloyl ring

Effects on T-cell proliferation

Thalidomide stimulates T cell proliferation and increases IFN-γ and IL-2 production

Lenalidomide is 100–1000 times more potent in stimulating T cell proliferation and IFN-γ and IL-2 production than thalidomide

Pomalidomide is similar to lenalidomide, in addition, it also enhances transcription factor T-bet, which reverts Th2 cells into Th1 like effector cells in vitro

Adverse Effects

Thalidomide has higher incidence of side effects like sedation, neuropathy and constipation.

Lenalidomide has lower incidence of adverse effects namely sedation, constipation and neuropathy than thalidomide.

Pomalidomide has lower incidence of adverse effects like sedation, constipation and neuropathy than thalidomide.

Teratogenecity

Thalidomide is a known teratogen.

Lenalidomide is not teratogenic in rabbit models

Pomalidomide is a known teratogen.