Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 04-05-2013, 05:32 PM #1
rob_d87 rob_d87 is offline
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Default What is Etanercept?

For some reason i came across this news article:

http://www.prnewswire.com/news-relea...179121491.html

Quote:
First Effective Treatment For Traumatic Brain Injury Reported by Institute of Neurological Recovery, Even Years After Injury
Quote:
LOS ANGELES, Nov. 14, 2012 /PRNewswire/ -- The first treatment breakthrough of its kind for survivors of traumatic brain injury (TBI) or stroke will be published in the December 1 issue of the journal CNS Drugs[1], with an accompanying editorial[2].
The ground-breaking study provides clinical evidence that, for the first time, chronic neurological dysfunction from stroke or traumatic brain injury can rapidly improve following a single dose of a drug that targets brain inflammation, even years after the initial event. There are 5 million people living in the U.S. after TBI and 4.5 million living in the U.S. after stroke, and this is the first treatment of its kind ever available for TBI or stroke survivors after hospital discharge.
The observational study[1] of 629 patients, conducted over the course of nearly two years, documents a diverse range of positive effects, including statistically significant rapid clinical improvement in motor impairment, spasticity, cognition, etc. in the stroke group, with a similar pattern of improvement seen in the traumatic brain injury (TBI) group. The study involved 617 patients treated an average of 42 months after stroke and 12 patients treated an average of 115 months after TBI, long after further spontaneous meaningful recovery would be expected. The study was conducted at the Institute of Neurological Recovery utilizing a novel drug delivery method, invented by Edward Tobinick M.D ., lead author of the study.
"These results represent a sea change in the therapeutic possibilities for stroke and TBI patients," said Steven Ralph PhD, Associate Professor at Griffith University School of Medical Science in Australia. Professor Ralph recently led a team of physicians to the INR for training in the new treatment method. "Our team observed, first hand, rapid clinical improvement in patients following this brief office treatment. Rarely do we see such a radical breakthrough in medical treatment as this. A previous example was the advance with thrombolytic therapy for acute stroke. However, no similar treatment has existed for this type of chronic brain dysfunction until now," said Professor Ralph.
The study's significance is underlined by average age of the TBI population, many of whom have been injured as teen-agers.
References
1. Selective TNF Inhibition for Chronic Stroke and Traumatic Brain Injury... CNS Drugs. 2012;26(12). DOI 10.1007/s40263-012-0013-2
2. New Hope for Survivors of Stroke and Traumatic Brain Injury. CNS Drugs. 2012;16(12). DOI 10.1007/s40263-012-0014-1
Source: INR
After diggin arond the references, it seems that the medication they use is Etanercept and according to another source (http://www.democraticunderground.com/10021951233#post1) they are charing $5000 for a single shot. Is it a scam?
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Old 04-05-2013, 05:37 PM #2
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No it is not a scam...it has always been expensive.

http://en.wikipedia.org/wiki/Etanercept
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Old 04-05-2013, 05:42 PM #3
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Quote:
Originally Posted by mrsD View Post
No it is not a scam...it has always been expensive.

http://en.wikipedia.org/wiki/Etanercept
But does it has any value as a treatment for TBI?
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Old 04-05-2013, 07:27 PM #4
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Etanercept is used to treat autoimmune disease inflammation symptoms. I wonder if it impacts the S-100b protein that causes an autoimmune reaction when it gets past the blood brain barrier after a TBI.

The TBI study group were far more seriously injured than concussions.
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Old 04-05-2013, 09:59 PM #5
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You have seen the commercials for it - Enbrel .

Drugs.com - Enbrel info.

Many of the NIH studies are showing that further study is needed, however it does look positive, with perispinous injections of etanercept; and I found one reference to the addition of minocycline with the etanercept.

And I did find this maybe referencing the S-100b protein and etanercept.
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Current: Changes of more insomnia, new reviews with findings of more Depression, tremors, vertigo, tinnitus, loss of focus, fatigue; SSDI - accepted on Depression, Cognitive Deficits; Seizures ruled out, mTBI changes including cognitive slowing/lapses.
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Old 04-06-2013, 12:43 AM #6
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I did not find any comments about S-100b protein in the etanercept articles. There are a number of weaknesses in the reports. They are open label meaning they expose the subjects that have taken the etanercept injection. They note quick improvements but I could not find any data for how long the improvements last. It also requires an injection into the

The contra-indications of TB and any immuno-compromised conditions make it a bit scary. The cost makes it unlikely for all but the worst injuries. If the Enbrel can be administered by a caregiver after an $800 training in Nicaragua, the minimum cost is $200 per week that may be extended to $200 per month at the very best. Every 2 weeks is more likely a optomistic outcome. Injections into the fatty tissue between C-5 and C-6 every week creates a risk. I would expect administration by a doctor or other licensed professional would easily increase this cost to $1000, considering malpractice issues. The protocol requires 12 weeks as a test phase although 4 weeks can be a minimum test phase in some cases.

The objective with very early stage Alzheimer's Disease is to get an improvement equal to 1 to 3 years prior to treatment date. Those of us who have seen the very early stages of AD recognize this as a recognizable but minor improvement.

This sounds more like an attempt to find new markets for a very expensive drug than a protocol that will gain approval by many payers.
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Old 04-06-2013, 02:30 AM #7
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I agree, it was late for me, I was rushed and tired, and didnt spend alot of time reading that one in depth enough.

Couldn't really find any indepth references to the S100-B protein and Enbrel.

These 2 present information calling for randomized studies, which we would all agree are needed: (They are referencing the same studies.)

TNF Inhibition

NIH Reference

If you research further into the references from NIH there is some reports that refer to the peri-spinal injections, and the administration - I believe that that topic is left to be covered by the administering facility, which in the US would be the Radiology Dept. who would most likely be administering them by Radiologic guided means. (Acknowledging the litigiousness nature of our culture)

IMO, there are many things about Enbrel, and many of those newer drugs for the auto-immune diseases are scarey . I don't know but a very few folks who are taking them, and so far they are comfortable with them, and I am happy they feel like they are receiving some improvements of their conditions; but after I have read the Warnings boxes of some of them, and with my ongoing condition, I would Balk at using them just because they do give me pause.

And with that said, I do not see how they could possibly have randomized studies without providing full disclosures on the Warnings of the totalilty of the side effects and not have study member flee from the room........

I wish them the best with their studies, I don't expect progress to be rapid in the case of these medications hitting the market soon though, for the US - but I have been wrong in the past.

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Current: Changes of more insomnia, new reviews with findings of more Depression, tremors, vertigo, tinnitus, loss of focus, fatigue; SSDI - accepted on Depression, Cognitive Deficits; Seizures ruled out, mTBI changes including cognitive slowing/lapses.
Medication update: Topamax 200mg twice daily it seems to minimize daily headaches to a 1-2/10 quality(I still know they are there); and acute headaches erupt without warnings.
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