The medicines available to patients across Europe are shaped by scientific advances and regulatory decisions. The European Medicines Agency (EMA) plays a central role in this process, assessing new medicines to ensure they meet standards of safety and effectiveness before they can be authorised for use.

New research from Trinity examines the medicines approved by the EMA over the last decade, offering insights into the chemistry and design of modern medicines and the scientific advances underpinning pharmaceutical innovation in Europe.

The first study looked at the shape of medicines approved by both the EMA and the US Food and Drug Administration (FDA) between 2013 and 2022. The shape of a medicine is important because it must fit precisely with its target in the body, much like a hand fitting into a glove. Some medicines can exist in two slightly different forms that are mirror images of each other, like left and right hands. Medicines may be developed using just one of these forms, called an enantiomer, or a mixture of both, called a racemate. 

To put this in context, thalidomide is an infamous example of a drug that exists in mirror image forms. Lack of understanding about mirror image forms of medicines was a significant contributing factor to the thalidomide tragedy in the 1950s and 1960s. This led to far stricter regulations for medicines approval. This year, the Nobel Prize was awarded for mirror image chemistry. The Nobel laureates discovered ways to make only one mirror image, which is incredibly difficult. 

The Trinity researchers found that approvals were much more likely to be enantiomers rather than racemates. This approach can sometimes improve how well a medicine works and may reduce unwanted side-effects, although it can also influence the cost of developing and manufacturing medicines.  

The second study examined the building blocks used in 380 new medicines approved between 2014 and 2023. The researchers found that many of these medicines contained specific ring-shaped chemical structures that include elements such as nitrogen or oxygen, called heterocycles. These structures play an important role in how medicines work in the body, and the study identified the building blocks most commonly used in modern drug design.