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Drug treatment for concussion ‘shows promise’

Pilot study reveals potential to tackle common symptoms of mild traumatic brain injury, further trials now expected

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A new drug treatment is showing promise in reducing common concussion symptoms, following the results of a pilot study. 

The use of ghrelin – a multifaceted gut hormone known for its stimulatory effects on food intake, fat deposition and growth hormone release – is being trialled as a means to combat the impact of concussion. 

The most common treatment for concussion is resting the brain by limiting physical and mental activities – but the results of the recent pilot show there could be promise in pharmaceutical intervention. 

Ghrelin is being developed synthetically as a concussion drug, OXE103, by Oxeia Biopharmaceuticals, which sponsored the clinical trial of off-label use with the University of Kansas Medical Center.

“This could also be a critical step forward for the 20 per cent or more of patients who have ongoing symptoms or have trouble with daily activities,” said Dr Michael Rippee, associate professor of neurology, who led the study. 

“Concussions can lead to a lifetime of health issues, including chronic headaches, depression, problems with thinking and memory, vision and balance issues and sleep disorders.”

Concussion, also referred to as mild traumatic brain injury, is sustained regularly in a host of environments, including sport. Its symptoms can persist for months, if not longer. 

“During a concussion, the blow to the head causes the brain to discharge its energy like the draining of a battery,” Dr Rippee said. 

“In addition, the movement of the brain within the skull during injury can lead to stretching damage to axons. This damage can slow down or inhibit information transfer between nerve cells. 

“Both the lack of energy and lack of effective information transfer in the brain results the symptoms we associate with concussion, such as problems with thinking, difficulty with emotions and issues with body function.”

The clinical trial involved 21 participants who had experienced a concussion within 28 days of the beginning of the study. Trial participants self-injected themselves with OXE103 twice a day for 14 days.

OXE103 is not a new drug, but it has never been studied in concussion. 

“It’s a synthetic version of a hormone that is produced in the stomach and enters the brain,” Dr Rippee said. 

“As a natural hormone product, it has been shown to be very safe and is well tolerated.”

Dr Rippee’s study found that trial participants significantly improved versus those who received a standard treatment of rest. Participants improved their scores on a test measuring quality of life after brain injury while reducing their scores on a post-concussion symptom test.

“I am encouraged by the results we are seeing from the trial,” said Dr Michael Wyand, chief executive of Oxeia Biopharmaceuticals. 

“The data provides hope for an effective treatment for the millions of people who suffer ongoing post-concussion symptoms as a result of a lack of effective treatment options.”

Preclinical models have shown that ghrelin impacts both the neurometabolic cascade, the disorder of the physiologic process that is characteristic of a concussion, and the associated axonal damage.

“While we recognise the limits of this study, including a small sample size, the results indicate that ghrelin is a promising potential therapy to treat concussions soon after occurrence,” Dr Rippee said, noting that a larger multi-centre randomised trial will be an important next step.

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