Antimuscarinic Medications Can Reverse Neuropathy, Scientists Say

A new use is found for old drugs

A study by an international team of researchers has found that a class of drugs used for other indications, such as nearsightedness, incontinence, and peptic ulcers, may also prevent neuropathy. Lead investigator Dr. Paul Fernyhough of the University of Manitoba said: “An exciting aspect of the work is that these are new uses for old drugs.”

The researchers found that antimuscarinic medications, such as atropine and pirenzepine, can reverse the numbness and pain often experienced by patients with diabetes or human immunodeficiency virus (HIV) infection, or as an adverse effect of cancer chemotherapy.

“The costs of treating these diseases and associated morbidities exceed the costs for treating breast cancer. For the first time, we have identified a new class of drugs that can reverse nerve damage in animal models of these diseases,” Fernyhough said.

In peripheral neuropathy, the nerve endings of the peripheral nerves die, severely affecting quality of life. For example, patients experience intractable pain, foot ulcers, infections, and ultimately amputations. There are no treatments for neuropathy other than palliative care.

The new study found that widely used drugs targeting a key receptor in the neural pathways can stimulate the growth of nerve fibers. The drugs drive nerve-fiber regeneration and repair in disease states such as diabetes and chemotherapy, where there is otherwise irreversible nerve damage, according to the investigators.

Fennyhough and colleagues have founded a biotech company, WinSanTor, to develop the therapeutic potential of this new approach to treating neuropathy.

“These data open the possibility that the process of peripheral nerve degeneration may be therapeutically reversible, and now with the potential to use existing drugs, we can rapidly translate these findings to clinical trials,” said Stanley Kim, co-founder and CEO of WinSanTor. “Peripheral neuropathy is a major and often-neglected health problem affecting hundreds of millions of people around the world, including a majority of diabetes patients, and we can’t afford to wait any longer in advancing treatments for this disease.”

Antimuscarinic drugs have been used in humans for more than 20 years without serious adverse effects, and they have an excellent safety profile, according to Fennyhough. “We expect phase 1 trials to progress smoothly, with phase 2 trials arranged and already funded for 2017,” he said.

The preclinical findings will be published this month in the Journal of Clinical Investigation.

Source: University of Manitoba; January 17, 2017.