Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review

Abstract Background Complications arising from acute traumatic spinal cord injury (SCI) are routinely managed by various pharmacological interventions. Despite decades of clinical application, the potential impact on neurological recovery has been largely overlooked. This study aims to highlight com...

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Main Authors: Lucie Bourguignon, Louis P. Lukas, Bethany R. Kondiles, Bobo Tong, Jaimie J. Lee, Tomás Gomes, Wolfram Tetzlaff, John L. K. Kramer, Matthias Walter, Catherine R. Jutzeler
Format: Article
Language:English
Published: Nature Portfolio 2024-10-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-024-00638-0
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author Lucie Bourguignon
Louis P. Lukas
Bethany R. Kondiles
Bobo Tong
Jaimie J. Lee
Tomás Gomes
Wolfram Tetzlaff
John L. K. Kramer
Matthias Walter
Catherine R. Jutzeler
author_facet Lucie Bourguignon
Louis P. Lukas
Bethany R. Kondiles
Bobo Tong
Jaimie J. Lee
Tomás Gomes
Wolfram Tetzlaff
John L. K. Kramer
Matthias Walter
Catherine R. Jutzeler
author_sort Lucie Bourguignon
collection DOAJ
description Abstract Background Complications arising from acute traumatic spinal cord injury (SCI) are routinely managed by various pharmacological interventions. Despite decades of clinical application, the potential impact on neurological recovery has been largely overlooked. This study aims to highlight commonly administered drugs with potential disease-modifying effects. Methods This systematic literature review included studies referenced in PubMed, Scopus and Web of Science from inception to March 31st, 2021, which assess disease-modifying properties on neurological and/or functional recovery of drugs routinely administered following spinal cord injury. Drug effects were classified as positive, negative, mixed, no effect, or not (statistically) reported. Risk of bias was assessed separately for animal, randomized clinical trials, and observational human studies. Results We analyzed 394 studies conducting 486 experiments that evaluated 144 unique or combinations of drugs. 195 of the 464 experiments conducted on animals (42%) and one study in humans demonstrate positive disease-modifying properties on neurological and/or functional outcomes. Methylprednisolone, melatonin, estradiol, and atorvastatin are the most common drugs associated with positive effects. Two studies on morphine and ethanol report negative effects on recovery. Conclusion Despite a large heterogeneity observed in study protocols, research from bed to bench and back to bedside provides an alternative approach to identify new candidate drugs in the context of SCI. Future research in human populations is warranted to determine if introducing drugs like melatonin, estradiol, or atorvastatin would contribute to enhancing neurological outcomes after acute SCI.
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spelling doaj-art-3e23e9b729bd4430b06b33fec65d52be2025-08-20T02:11:47ZengNature PortfolioCommunications Medicine2730-664X2024-10-014111310.1038/s43856-024-00638-0Impact of commonly administered drugs on the progression of spinal cord injury: a systematic reviewLucie Bourguignon0Louis P. Lukas1Bethany R. Kondiles2Bobo Tong3Jaimie J. Lee4Tomás Gomes5Wolfram Tetzlaff6John L. K. Kramer7Matthias Walter8Catherine R. Jutzeler9Department of Health Sciences and Technology, ETH ZurichDepartment of Health Sciences and Technology, ETH ZurichInternational Collaboration on Repair Discoveries (ICORD), University of British ColumbiaInternational Collaboration on Repair Discoveries (ICORD), University of British ColumbiaInternational Collaboration on Repair Discoveries (ICORD), University of British ColumbiaDepartment of Biosystems Science and Engineering, ETH ZurichInternational Collaboration on Repair Discoveries (ICORD), University of British ColumbiaInternational Collaboration on Repair Discoveries (ICORD), University of British ColumbiaDepartment of Urology, University Hospital Basel, University of BaselDepartment of Health Sciences and Technology, ETH ZurichAbstract Background Complications arising from acute traumatic spinal cord injury (SCI) are routinely managed by various pharmacological interventions. Despite decades of clinical application, the potential impact on neurological recovery has been largely overlooked. This study aims to highlight commonly administered drugs with potential disease-modifying effects. Methods This systematic literature review included studies referenced in PubMed, Scopus and Web of Science from inception to March 31st, 2021, which assess disease-modifying properties on neurological and/or functional recovery of drugs routinely administered following spinal cord injury. Drug effects were classified as positive, negative, mixed, no effect, or not (statistically) reported. Risk of bias was assessed separately for animal, randomized clinical trials, and observational human studies. Results We analyzed 394 studies conducting 486 experiments that evaluated 144 unique or combinations of drugs. 195 of the 464 experiments conducted on animals (42%) and one study in humans demonstrate positive disease-modifying properties on neurological and/or functional outcomes. Methylprednisolone, melatonin, estradiol, and atorvastatin are the most common drugs associated with positive effects. Two studies on morphine and ethanol report negative effects on recovery. Conclusion Despite a large heterogeneity observed in study protocols, research from bed to bench and back to bedside provides an alternative approach to identify new candidate drugs in the context of SCI. Future research in human populations is warranted to determine if introducing drugs like melatonin, estradiol, or atorvastatin would contribute to enhancing neurological outcomes after acute SCI.https://doi.org/10.1038/s43856-024-00638-0
spellingShingle Lucie Bourguignon
Louis P. Lukas
Bethany R. Kondiles
Bobo Tong
Jaimie J. Lee
Tomás Gomes
Wolfram Tetzlaff
John L. K. Kramer
Matthias Walter
Catherine R. Jutzeler
Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
Communications Medicine
title Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
title_full Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
title_fullStr Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
title_full_unstemmed Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
title_short Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
title_sort impact of commonly administered drugs on the progression of spinal cord injury a systematic review
url https://doi.org/10.1038/s43856-024-00638-0
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