CNM-Au8 Reduces Neurofilament Light, Candesartan Benefits Headache, Ketamine Shows Potential in Migraine

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Welcome to this special edition of Neurology News Network. I’m Marco Meglio.

New data from the ongoing HEALEY ALS platform trial from Regimen C, which is assessing Clene Nanomedicine’s investigational agent CNM-Au8 among patients with amyotrophic lateral sclerosis (ALS), suggest that the treatment resulted in statistically significant reductions in neurofilament light (NfL) compared with placebo after 24 weeks of therapy. CNM-Au8 is an oral suspension of gold nanocrystals developed by Clene in an attempt to restore neuronal health and function by increasing energy production and utilization. All told, in this analysis and across the full cohort of patients (n = 161) in Regimen C, the least-squares (LS) mean change in natural logarithm of plasma NfL was –0.024 for patients on CNM-Au8 compared with 0.076 among patients randomly assigned to placebo

Findings from a small-scale retrospective chart review study provided evidence that candesartan, an antihypertensive drug, was well-tolerated and may be helpful in reduction of mean monthly headache days in adolescents with a high baseline headache frequency. Investigators concluded that patients may gain more benefit from the drug if used as a first-line treatment earlier in the disease course. Of the sample, chronic migraine was the most common diagnosis (54%), followed by new daily persistent headache (17%), episodic migraine (17%), and post-traumatic headache (12%). Mean monthly headache frequency, the primary outcome, was significantly reduced following treatment with candesartan, with patients experiencing an average of 23.3 days per month prior to initiation vs 19.6 days after (P = .04).

Findings from a recent study of pediatric patients with refractory migraine demonstrated a significant reduction in pain at discharge using intravenous ketamine as a treatment with no serious adverse events. These results suggest that intravenous ketamine is an effective, safe, and well-tolerated option for treating refractory pediatric headaches and status migrainosus. All told, the median percent pain reduction at discharge was 50% among 58 encounters with pediatric patients with refractory migraine. Of note, 64% of patients did not have headache recurrence or exacerbation in 1 month after discharge. Notably, the median time to recurrence was 7 days for those that recurred and 9% had recurrence in 72 hours postdischarge.

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