Perispinal Delivery of CNS Drugs

Perispinal.Delivery.coverMay 2, 2016 (Los Angeles, Boca Raton): On April 27, 2016, the peer-reviewed review article entitled, Perispinal Delivery of CNS Drugs, by Edward Tobinick MD, published online in the scientific journal CNS Drugs. The article published in print in the June issue of the journal. The abstract of the article states:

Perispinal injection is a novel emerging method of drug delivery to the central nervous system (CNS). Physiological barriers prevent macromolecules from efficiently penetrating into the CNS after systemic administration. Perispinal injection is designed to use the cerebrospinal venous system (CSVS) to enhance delivery of drugs to the CNS. It delivers a substance into the anatomic area posterior to the ligamentum flavum, an anatomic region drained by the external vertebral venous plexus (EVVP), a division of the CSVS. Blood within the EVVP communicates with the deeper venous plexuses of the CSVS. The anatomical basis for this method originates in the detailed studies of the CSVS published in 1819 by the French anatomist Gilbert Breschet. By the turn of the century, Breschet’s findings were nearly forgotten, until rediscovered by American anatomist Oscar Batson in 1940. Batson confirmed the unique, linear, bidirectional and retrograde flow of blood between the spinal and cerebral divisions of the CSVS, made possible by the absence of venous valves. Recently, additional supporting evidence was discovered in the publications of American neurologist Corning. Analysis suggests that Corning’s famous first use of cocaine for spinal anesthesia in 1885 was in fact based on Breschet’s anatomical findings, and accomplished by perispinal injection. The therapeutic potential of perispinal injection for CNS disorders is highlighted by the rapid neurological improvement in patients with otherwise intractable neuroinflammatory disorders that may ensue following perispinal etanercept administration. Perispinal delivery merits intense investigation as a new method of enhanced delivery of macromolecules to the CNS and related structures.

Note added in July 2016: A related article, entitled “Perispinal Delivery of CNS Drugs: From Corning to Perispinal Etanercept”, published on July 9, 2016, on the Brain Immune Trends website, accessible by clicking here.

The full-text of the article is available by clicking on the link below:

Perispinal Delivery of CNS DrugsEdward Tobinick MD. CNS Drugs. 2016;30(6):469-80. do:10.1007/s40263-016-0339-2, published online 27 April 2016. (Download free full-text PDF).

Randomized, double-blind, placebo-controlled etanercept for Alzheimer's clinical trial results publish

Issue 10, volume 4, Supplement of Alzheimer’s and Dementia: Journal of the Alzheimer’s Association, Session 04-11-02, P273, entitled “The Safety and Tolerability of etanercept in Alzheimer’s disease (STEADI-09): A Phase II Double Blind Randomised Placebo Controlled Trial”, principal investigator Clive Holmes MD, University of Southampton, Southampton, United Kingdom, contains the first double-blind, randomized, placebo-controlled data supporting the therapeutic efficacy of etanercept for treatment of Alzheimer’s disease. The abstract of this study (full-text here) published in this issue in July 2014. The abstract concludes:

This study shows good tolerability and safety of Etanercept in the subjects with Alzheimer’s Disease. This study is also supportive of beneficial cognitive, behavior and activities of daily living in subjects taking subcutaneous Etanercept.”

A 2008 article in BBC News had previously discussed the favorable results of etanercept for treatment of Alzheimer’s disease in a study whose lead author was Edward Tobinick M.D. The article reported at the time that Clive Holmes MD was interested in taking on further research utilizing this treatment approach.