Surgeons in Southampton aim to improve outcomes for brain haemorrhage patients in the trial of a new drug based on an antioxidant found in broccoli.
Diederik Bulters, consultant neurosurgeon at Southampton General Hospital, and his team are assessing the effect of experimental drug SFX-01 on patients receiving treatment for a bleed on the brain known as a subarachnoid haemorrhage (SAH), a type of stroke.
Preventing brain damage
SAH is normally caused by a weakness in the wall of a blood vessel that bursts open, leading to a haemorrhage in the brain. More than 6,000 people in England, mainly aged between 45 and 70, are admitted to neurointensive care units with SAH every year. Around half of all cases are fatal, while many of those who survive are left disabled and suffer long-term cognitive and emotional problems.
Currently, patients undergo a surgical procedure to repair the bleed. They then receive nimodipine to prevent the common complication cerebral ischaemia, which restricts blood flow to the brain through narrowing of the arteries.
Extracting the benefits of broccoli
Mr Bulters was already investigating sulforaphane, a chemical antioxidant found in broccoli as a potential treatment for SAH, when Evgen Pharma began developing a synthetic form, SFX-01, as a drug for breast cancer. After promising early results in the laboratory, Evgen agreed to sponsor a clinical trial of SFX-01 for SAH.
Sulforaphane is one of a group of plant chemicals – phytochemicals – that are strong antioxidants and can alter our blood vessels’ functions. By improving blood flow to the brain, SFX-01 could help to prevent complications after SAH. It’s a significant moment for the team, realising the potential benefits of sulforaphane in a form that is stable enough to be administered as a drug.
The trial will involve 90 patients over two years, with those receiving SFX-01 given either a 300mg dose capsule or dissolved via nasogastric tube, together with standard treatment nimodipine.
Building on a history of excellence
Nimodipine itself, the only drug currently proven to improve outcomes for SAH patients, was successfully trialled at Southampton General Hospital in a 1989 landmark study. The team now hope to further improve treatment and outcomes by adding SFX-01 as a second effective treatment.
The hope is that SFX-01 will further reduce complications when used in conjunction with nimodipine, by controlling inflammation and improving blood flow. If successful, the trial will be the first significant clinical development in SAH treatment for more than 20 years.
Posted on Thursday 16 June 2016