title: Investigational drugs for the treatment of spinal cord injury: review of preclinical studies and evaluation of clinical trials from Phase I to II.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: University Health Network, Toronto Western Hospital, Krembil Neuroscience Center , Toronto, ON M5T 2S8 , Canada +1 416 603 5229 ; +1 416 603 6274 ; Michael.Fehlings@uhn.ca.
authors: Narihito
authors: N
authors: Nagoshi
authors: Michael G
authors: MG
authors: Fehlings
mesh_terms: D000818:Animals; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D015195:Drug Design; D004353:Drug Evaluation, Preclinical; D015507:Drugs, Investigational / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D017063:Outcome Assessment, Health Care; D013119:Spinal Cord Injuries / Q000188:drug therapy*
chemical_list: D015507:Drugs, Investigational
keywords: Rho protein antagonist; basic fibroblast growth factor; clinical trials in Phase II; magnesium; minocycline; riluzole; spinal cord injury