Rapid improvement in severe long COVID following perispinal etanercept, 2022, Tobinick et al

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Braganca

Senior Member (Voting Rights)
https://www.tandfonline.com/doi/abs/10.1080/03007995.2022.2096351

This study aimed to describe the neurological improvements in a patient with severe long COVID brain dysfunction following perispinal etanercept administration. Perispinal administration of etanercept, a novel method designed to enhance its brain delivery via carriage in the cerebrospinal venous system, has previously been shown to reduce chronic neurological dysfunction after stroke. Etanercept is a recombinant biologic that is capable of ameliorating two components of neuroinflammation: microglial activation and the excess bioactivity of tumor necrosis factor (TNF), a proinflammatory cytokine that is a key neuromodulator in the brain. Optimal synaptic and brain network function require physiological levels of TNF. Neuroinflammation, including brain microglial activation and excess central TNF, can be a consequence of stroke or peripheral infection, including infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19.
 
Dude might be dodgy but his idea, is not so bad? Is mentioned similar in other places. Is it a good idea??? Good idea bad person.?

From my layman's perspective, it seems he's guilty of the same things drug companies do, off label marketing?? A marketing problem.

I'm glad somebody looked into before this, I was rather convinced though I noted the man held patents... And recognised conflict of interest. I wouldn't have ever found the quack watch stuff. Is he just overzealous, reckless, or a fraud?

Okay a lil more reading and... The alzeheimers and neurological stuff is quack, but the stroke and pain could be legit! Can anybody with more knowledge help confirm

I came across thinking of centrally administered anakinra, infliximab, canakinumab for fibromyalgia

2 RCT if centrally administered etarnacept for pain

https://pubmed.ncbi.nlm.nih.gov/24165696/ https://pubmed.ncbi.nlm.nih.gov/26243249/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051899/
The use of cytokine inhibitors and glial modulators in clinical trials has shown some encouraging results. Intractable discogenic lower back pain patients showed up to 8 weeks of pain relief when given a single intradiscal treatment of entanercept, a TNF inhibitor 245. Additionally, lumbar disc herniation patients who received entanercept via transforaminal epidural injections had up to 26 weeks of pain relief following two injections in a randomized, double-blind, and placebo-controlled trial246. Another cytokine inhibitor, the IL-1 trap rilonacept, is well tolerated by patients, and in a proof-of-concept study, treatment with the drug showed pain relief for a small group of patients being treated for chronic refractory gouty arthritis247. By contrast, subcutaneous inhibition of IL-1β with anakinra has no beneficial effect on chronic fatigue syndrome CFS248. Microglial activation can be blocked in vitro by low doses of naltrexone 249, and a pilot trial also showed that treatment with the drug can help to reduce symptoms related to fibromyalgia.250.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609632/
Therapeutics targeting IL-1β or the IL-1Ra have been proposed for a variety of pathologies, including autoinflammatory conditions, rheumatoid arthritis, and atherosclerosis, among others [91]. The FDA approved an anti-IL-1β monoclonal antibody (Canakinumab) to treat a spectrum of autoinflammatory syndromes known as cryopyrin-associated periodic syndromes (CAPS). More recently, clinical trials explored the ability of Canakinumab to protect against atherosclerotic disease (the CANTOS study). Interestingly, the results demonstrated that anti-IL-1β therapy via subcutaneous administration could prevent recurrence of cardiovascular disease while also protecting against arthritis, gout, and cancer [92]. Additionally, subcutaneous administration of an IL-1Ra (Anakinra) neutralizing antibody has shown promise for treating patients with rheumatoid arthritis, acute stroke, and autoinflammation-associated epilepsy syndrome [91, 93, 94]. Of note, both Canakinumab and Anakinra appear to be relatively well tolerated [91], and both achieve a reasonably high degree of bioavailability (75–92%) when administered subcutaneously [95, 96]. The mean terminal half-life of the two agents appears to differ considerably, with Canakinumab achieving approximately 26 days [95], compared to 4–6 h for Anakinra [96], although this may be quite different if administered directly into the CNS environment (e.g., intrathecal administration) for direct targeting of CNS nociceptors or glia. Given the promise of IL-1R/IL-1β antagonists/inhibitors in preclinical models of acute and chronic pain, testing whether Canakinumab or Anakinra can provide relief to patients suffering from severe chronic pain warrants investigation

https://www.drugs.com/medical-answers/etanercept-work-stroke-recovery-3572317/

https://pubmed.ncbi.nlm.nih.gov/31899977/
For stroke
 
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