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【medical-news】治疗慢性坐骨神经痛的新希望

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New Hope for Relief of Chronic Sciatica

http://www.prweb.com/releases/sciatica/etanercept/prweb2377304.htm

New hope for hundreds of thousands of people suffering from chronic sciatica was revealed this week in a Phase II randomized, double-blind, placebo-controlled trial. Researchers from the Walter Reed Army Medical Center reported that localized (epidural) administration of etanercept, a unique therapeutic that neutralizes TNF (tumor necrosis factor), holds promise as a treatment for sciatica. Epidural etanercept for sciatica was invented by a California physician, Edward Tobinick MD, Director of the Institute for Neurological Research in Los Angeles.

Los Angeles, CA (PRWEB) April 30, 2009 -- New hope for hundreds of thousands of people suffering from chronic sciatica was revealed this week in a Phase II randomized, double-blind, placebo-controlled trial. Researchers from the Walter Reed Army Medical Center reported(1) that localized (epidural) administration of etanercept, a unique therapeutic that neutralizes TNF (tumor necrosis factor), holds promise as a treatment for sciatica. Epidural etanercept for sciatica was invented by a California physician, Edward Tobinick MD[2. Sciatica, nerve root pain radiating down the leg, is most often associated with a herniated disc in the lower back. Basic science research has suggested that excess TNF, a molecule which amplifies the inflammatory response, is centrally involved in sciatica and other forms of disc-related and neuropathic pain.

The Walter Reed study, published in the May 2009 issue of the journal Anesthesiology(2), provides the first randomized, double-blind, placebo-controlled data supporting the novel concept that etanercept could be used locally for a neurology indication. This concept was pioneered and patented not by the drug's manufacturer, but rather by Dr. Tobinick at the Institute for Neurological Research in Los Angeles. For the past ten years he has been, and is currently, using locally administered etanercept for treatment of patients with intractable sciatica, back and neck pain(3,4,5,6). This type of off-label use is an example of a repositioned use of an existing therapeutic, a topic of increasing interest to the pharmaceutical industry(7).

Also this week, in the May 5, 2009 issue of the journal Neuroscience, Kato and colleagues from the University of California, San Diego(8) reported that locally administered etanercept reaches the inside of injured nerves and reduces pain-related behavior in animals. The Neuroscience study cites three of the previous scientific publications of Dr. Tobinick(3,5,6). These new studies therefore provide further scientific support for the concept of local therapeutic administration of etanercept for disc-related pain.

These publications provide substantial new scientific data. However, FDA-approval is a long and difficult process, and prior to approval drug manufacturers are prohibited by the FDA from promoting any off-label use of any of their medications to the public. Nevertheless, the prospect of a new, non-surgical approach for chronic sciatica is exciting, and further investigation is already underway.

References

1. Cohen, S.P., N. Bogduk, A. Dragovich, C.C. Buckenmaier, 3rd, S. Griffith, C. Kurihara, J. Raymond, P.J. Richter, N. Williams, and T.L. Yaksh, Randomized, double-blind, placebo-controlled, dose-response, and preclinical safety study of transforaminal epidural etanercept for the treatment of sciatica. Anesthesiology, 2009. 110(5): p. 1116-26.
2. U.S. patent 6,419,944, filed April 5, 2001; also 6,537,549; and 6,982,089, issued to Edward Tobinick MD and assigned to TACT IP, LLC, and additional patents and related applications, assigned to TACT IP, LLC.
3. Tobinick, E.L. and S. Britschgi-Davoodifar, Perispinal TNF-alpha inhibition for discogenic pain. Swiss Med Wkly, 2003. 133(11-12): p. 170-7.
4. Tobinick, E.L., Targeted etanercept for discogenic neck pain: uncontrolled, open-label results in two adults. Clin Ther, 2003. 25(4): p. 1211-8.
5. Tobinick, E. and S. Davoodifar, Efficacy of etanercept delivered by perispinal administration for chronic back and/or neck disc-related pain: a study of clinical observations in 143 patients. Curr Med Res Opin, 2004. 20(7): p. 1075-85.
6. Tobinick, E., Perispinal etanercept for neuroinflammatory disorders. Drug Discov Today, 2009. 14(3-4): p. 168-77.
7. Tobinick, E., The value of drug repositioning in the current pharmaceutical market. Drug News and Perspectives 2009 Mar-Apr 22(2).
8. Kato, K., S. Kikuchi, V.I. Shubayev, and R.R. Myers, Distribution and tumor necrosis factor-alpha isoform binding specificity of locally administered etanercept into injured and uninjured rat sciatic nerve. Neuroscience, 2009. 160(2): p. 492-500.

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2009-05-02 19:06

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New Hope for Relief of Chronic Sciatica
治疗慢性坐骨神经痛的新希望
http://www.prweb.com/releases/sciatica/etanercept/prweb2377304.htm

New hope for hundreds of thousands of people suffering from chronic sciatica was revealed this week in a Phase II randomized, double-blind, placebo-controlled trial. Researchers from the Walter Reed Army Medical Center reported that localized (epidural) administration of etanercept, a unique therapeutic that neutralizes TNF (tumor necrosis factor), holds promise as a treatment for sciatica. Epidural etanercept for sciatica was invented by a California physician, Edward Tobinick MD, Director of the Institute for Neurological Research in Los Angeles.
本周在一项II期随机、双盲、安慰剂对照试验中揭晓了几十万慢性坐骨神经痛患者的治疗新希望。Walter Reed部队医学中心的研究者们报道：一种通过中和TFN（肿瘤坏死因子）的独特疗法即硬膜外局部（依那西普）给药有希望能治疗坐骨神经痛。该疗法是由一名加利福尼亚医生创建的，他就是位于洛杉矶的神经研究所所长Edward Tobinick医学博士。

CA (PRWEB) April 30, 2009 -- New hope for hundreds of thousands of people suffering from chronic sciatica was revealed this week in a Phase II randomized, double-blind, placebo-controlled trial. Researchers from the Walter Reed Army Medical Center reported(1) that localized (epidural) administration of etanercept, a unique therapeutic that neutralizes TNF (tumor necrosis factor), holds promise as a treatment for sciatica. Epidural etanercept for sciatica was invented by a California physician, Edward Tobinick MD[2. Sciatica, nerve root pain radiating down the leg, is most often associated with a herniated disc in the lower back. Basic science research has suggested that excess TNF, a molecule which amplifies the inflammatory response, is centrally involved in sciatica and other forms of disc-related and neuropathic pain.
PRWED网2009年4月30日——本周在一项II期随机、双盲、安慰剂对照试验中揭晓了几十万慢性坐骨神经痛患者的治疗新希望。Walter Reed部队医学中心的研究者们报道[1]：一种通过中和TFN（肿瘤坏死因子）的独特疗法即硬膜外局部（依那西普）给药有希望能治疗坐骨神经痛。该疗法是由一名加利福尼亚医生Edward Tobinick医学博士[2]创建的。坐骨神经痛患者的神经根性疼痛往往放射至小腿，该病与下背部的椎间盘突出密切相关。基础科学研究已表明，肿瘤坏死因子过多是造成坐骨神经痛、其他椎间盘相关因素和神经性疼痛的主要原因，而该因子是一种增强炎症反应的分子。

The Walter Reed study, published in the May 2009 issue of the journal Anesthesiology(2), provides the first randomized, double-blind, placebo-controlled data supporting the novel concept that etanercept could be used locally for a neurology indication. This concept was pioneered and patented not by the drug's manufacturer, but rather by Dr. Tobinick at the Institute for Neurological Research in Los Angeles. For the past ten years he has been, and is currently, using locally administered etanercept for treatment of patients with intractable sciatica, back and neck pain(3,4,5,6). This type of off-label use is an example of a repositioned use of an existing therapeutic, a topic of increasing interest to the pharmaceutical industry(7).
Walter Reed study的研究首次提供了一组随机、双盲、安慰剂对照数据，通过阐明一种新观念即对某种神经病学适应症能局部给予依那西普，该文已在2009年5月出版的麻醉学杂志发表。这种观念的提倡和首创者不是药物制造商，而是洛杉矶神经病学研究所的Tobinick博士。在过去的10年直至现在，他一直使用依那西普局部给药治疗难治性坐骨神经痛、颈肩痛[4,5,6]。作为一种制药企业日益感兴趣的研究课题，这种非常规的使用是对复辟目前疗法的一个例子。

Also this week, in the May 5, 2009 issue of the journal Neuroscience, Kato and colleagues from the University of California, San Diego(8) reported that locally administered etanercept reaches the inside of injured nerves and reduces pain-related behavior in animals. The Neuroscience study cites three of the previous scientific publications of Dr. Tobinick(3,5,6). These new studies therefore provide further scientific support for the concept of local therapeutic administration of etanercept for disc-related pain.
也就是这周在2009年5月出版的麻醉学杂志上，加利福尼亚大学的Kato和同事们联合San Diego[8]共同报道了，动物实验中依那西普的局部给药能到达受损的神经并减少疼痛相关行为。神经科学研究引证了3个Tobinick[3,5,6]博士先前发表的科学刊物。因此，这些新的研究结果更进一步提供了该观念的科学依据，即椎间盘相关性疼痛时给予给予依那西普的疗法。

These publications provide substantial new scientific data. However, FDA-approval is a long and difficult process, and prior to approval drug manufacturers are prohibited by the FDA from promoting any off-label use of any of their medications to the public. Nevertheless, the prospect of a new, non-surgical approach for chronic sciatica is exciting, and further investigation is already underway.
这些刊物提供了新的实质性的科学数据。然而，要得到FDA的批准是一个漫长而艰难的过程，首先是要批准FDA禁止药物制造商促进向公众推荐任何药物治疗的非常规使用这一条款。然而，对慢性坐骨神经痛的一种新保守疗法的前景是鼓舞人心的，而更进一步的研究业已启动。

编译：
治疗慢性坐骨神经痛的新希望

本周在一项II期随机、双盲、安慰剂对照试验中揭晓了几十万慢性坐骨神经痛患者的治疗新希望。Walter Reed部队医学中心的研究者们报道：一种通过中和TFN（肿瘤坏死因子）的独特疗法即硬膜外局部（依那西普）给药有希望能治疗坐骨神经痛。该疗法是由一名加利福尼亚医生创建的，他就是位于洛杉矶的神经研究所所长Edward Tobinick医学博士。

PRWED网2009年4月30日——本周在一项II期随机、双盲、安慰剂对照试验中揭晓了几十万慢性坐骨神经痛患者的治疗新希望。Walter Reed部队医学中心的研究者们报道[1]：一种通过中和TFN（肿瘤坏死因子）的独特疗法即硬膜外局部（依那西普）给药有希望能治疗坐骨神经痛。该疗法是由一名加利福尼亚医生Edward Tobinick医学博士[2]创建的。坐骨神经痛患者的神经根性疼痛往往放射至小腿，该病与下背部的椎间盘突出密切相关。基础科学研究已表明，肿瘤坏死因子过多是造成坐骨神经痛、其他椎间盘相关因素和神经性疼痛的主要原因，而该因子是一种增强炎症反应的分子。

Walter Reed study的研究首次提供了一组随机、双盲、安慰剂对照数据，通过阐明一种新观念即对某种神经病学适应症能局部给予依那西普，该文已在2009年5月出版的麻醉学杂志发表。这种观念的提倡和首创者不是药物制造商，而是洛杉矶神经病学研究所的Tobinick博士。在过去的10年直至现在，他一直使用依那西普局部给药治疗难治性坐骨神经痛、颈肩痛[4,5,6]。作为一种制药企业日益感兴趣的研究课题，这种非常规的使用是对复辟目前疗法的一个例子。

也就是这周在2009年5月出版的麻醉学杂志上，加利福尼亚大学的Kato和同事们联合San Diego[8]共同报道了，动物实验中依那西普的局部给药能到达受损的神经并减少疼痛相关行为。神经科学研究引证了3个Tobinick[3,5,6]博士先前发表的科学刊物。因此，这些新的研究结果更进一步提供了该观念的科学依据，即椎间盘相关性疼痛时给予给予依那西普的疗法。

这些刊物提供了新的实质性的科学数据。然而，要得到FDA的批准是一个漫长而艰难的过程，首先是要批准FDA禁止药物制造商促进向公众推荐任何药物治疗的非常规使用这一条款。然而，对慢性坐骨神经痛的一种新保守疗法的前景是鼓舞人心的，而更进一步的研究业已启动。

2009-05-04 17:41