Emerging treatments

Anti-Nogo antibody

Currently in the early stages of clinical investigation. One first-in-human study found that the human anti-Nogo-A antibody ATI355 was well tolerated in patients with acute, complete traumatic paraplegia and tetraplegia.[138] A phase 2 trial is ongoing.[139]

Riluzole

Exerts a potentially protective effect on white matter by blocking the influx of sodium into damaged cells.[140] Two phase 1 trials in acute spinal cord injury have completed, and one phase 2/3 trial was initiated but terminated early due to slow enrolment.[141][142][143][144]

Minocycline

A tetracycline antibiotic that has been found to attenuate neuroinflammation, inhibit apoptosis, and prevent neuronal damage.[140] In one phase 2 clinical trial, patients receiving minocycline experienced greater motor recovery than those receiving placebo; a phase 3 trial is ongoing.[145][146]

Cethrin

A bacterial-derived toxin (BA-210) combined with a haemostatic adhesive, cethrin improved motor function in one phase 1/2a trial of patients with thoracic or cervical spinal cord injury.[147] Further clinical trials are planned.

Basic fibroblast growth factor (basic FGF)

It has been hypothesised that basic FGF might improve functional and respiratory parameters, presumably by reducing glutamate-mediated excitotoxicity. One phase 1/2 trial of basic FGF injection at the site of injury is ongoing.

Neuromodulation

There is some evidence to suggest that neuromodulation can aid rehabilitation efforts.[148] One phase 2 trial is ongoing.[149]

Stem-cell therapy

Bone marrow-derived stem cells appeared to improve bladder function, quality of life, and motor function in small studies of patients with spinal cord injury.[150][151] Some patients treated with activated autologous macrophages or olfactory ensheathing cells experienced modest motor improvement, but results were inconsistent.[152][153][154]

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