Journal
EXPERT OPINION ON INVESTIGATIONAL DRUGS
Volume 24, Issue 5, Pages 645-658Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/13543784.2015.1009629
Keywords
basic fibroblast growth factor; clinical trials in Phase II; magnesium; minocycline; Rho protein antagonist; riluzole; spinal cord injury
Categories
Funding
- AOSpine North America
- AOSpine International
- NACTN
- Rick Hansen Institute
- Ontario Neurotrauma Foundation
- Hadassah Medical Organization
- BioAxone BioSciences, Inc.
- Acorda Therapeutics, Inc.
- Asubio Pharmaceuticals, Inc.
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Introduction: Efforts in basic research have clarified mechanisms involved in spinal cord injury (SCI), and resulted in positive findings using experimental treatments including cell transplantation and drug administration preclinically. Based on accumulated results, various clinical trials have begun for human SCI. Areas covered: In this review, the authors focus on five investigational drugs: riluzole, minocycline, Rho protein antagonist, magnesium chloride in polyethylene glycol formulation, and basic fibroblast growth factor. All drugs have established safety and tolerability from Phase I clinical trials, and are now in Phase II. They have been proven to have neuroprotective and/or neuroregenerative effects in animal models of SCI. Expert opinion: To date, diverse drugs have been translated into clinical trials, but none have reached clinical application. A key gap was the lack of reliable biomarkers for SCI to fast-track Phase I/II trials. Furthermore, problems were often due to lack of adequate outcome assessments for both animal models and SCI patients. In order to advance clinical trials more quickly and with greater success, more clinically relevant animal models should be used in basic research. Clinically, it is indispensable to use appropriate outcome measurements and to construct a wide network among clinical centers to validate the efficacy of drugs.
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