Drug shows stronger motor recovery


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A common side effect of a spinal cord injury is the fact that subjects tend to develop neuropathic pain. This kind of pain is not associated to a specific physical damage, and can be felt for the entire life, often affecting the quality of life. In some cases, subjects received an early treatment of gabapentinoids, a class of anticonvulsants drugs that are known to diminish neuropathic pain.

Study shows stronger recovery
Wings for Life was supporting a retrospective observational study in a large multi-center cohort of spinal cord injured patients. Over a group of 625 individuals, 150 patients received the anticonvulsants, 83 within one month after their spinal cord injury, 72 at a later time and 470 no or another medication. When comparing these groups, researchers found that the early treatment was associated with a significantly stronger motor recovery, a surprising effect for a painkilling drug.

The fact that this medication works only within one month after injury, combined with prior experimental observations suggest that the recovery comes from both neuroprotection and regeneration after injury. These observations support a currently Wings for Life funded preclinical study investigating the molecular mechanism of gabapentinoids on axon regeneration.

Suitable candidates for repurposing
The results of this study prove that gabapentinoids are an interesting class of drugs to promote functional recovery after such injury. First, they are already approved and commonly prescribed drugs. This eliminates the problem of unknown potential side effects and saves years of testing to prove that the drug is safe. This also means that the costs to promote the use of these drugs would also be limited, as it would only require slightly adapting practice guidelines for neuropathic pain that are already in place. Finally, what makes gabapentinoids good candidates for a future clinical trial is the fact that they can be administered within one month after the injury. This is a rather long window of opportunity for delivery, when compared to others that must be done within a few hours or days.

Next steps
Future analysis should define the exact time and optimal dosage at which gabapentinoids have their maximum beneficial effect. Future studies should monitor if the benefit of motor recovery can be translated into a meaningful improvement of any function like walking or hands movements.

 

Source: “Early Administration of Gabapentinoids Improves Motor Recovery after Human Spinal Cord Injury” Warner FM, Cragg JJ, Jutzeler CR, Röhrich F, Weidner N, Saur M, Maier DD, Schuld C; EMSCI Sites, Curt A, Kramer JK. Cell Reports, February 14, 2017.