Spinal cord injury pharmacotherapy: Current research & development and competitive commercial landscape as of 2015

This review describes the pharmacotherapy landscape in SCI from both commercial and research and development (R&D) standpoints through March 2015. The purpose of this report is to provide a frame of reference to understand the obstacles and successes related to SCI therapeutic development and as a historical perspective of the SCI landscape as of 2015. The direction of R&D for SCI treatments will continue to be driven by 1) patient need, 2) the opportunity to reduce cost of care and loss of productivity, and 3) emerging scientific and technological breakthroughs, such as nanomedicine, specific tissue targeting, cell therapies, and precision medicine.

• 1
  There is urgent need to develop disease-modifying therapy for SCI, yet the commercial landscape remains small and highly fragmented with a paucity of novel late-stage compounds in R&D.
• 2
  Four primary mechanisms are under investigation and may yield promising therapeutic targets: 1) neuronal regeneration; 2) neuroprotection (including anti-inflammation); 3) axonal reconnection; and 4) neuromodulation and signal enhancement.
• 3
  Most SCI programs continue to focus on motor improvement by targeting disease-modifying mechanisms, i.e. interfering injury potentiation or enhancing repair processes.