Safety and efficacy of riluzole in patients undergoing decompressive surgery for degenerative cervical myelopathy (CSM-Protect): a multicentre, double-blind, placebo-controlled, randomised, phase 3 trial
RCT (n=300) found that 6 weeks adjuvant perioperative treatment with riluzole did not improve functional recovery (modified Japanese Orthopaedic Association) beyond decompressive surgery in patients with moderate-to-severe degenerative cervical myelopathy vs placebo.
Source:
The Lancet Neurology
SPS commentary:
A related commentary discusses this study. It states that riluzole might be an appropriate drug for this application, but perhaps the dose used was too low or the drug was not prescribed at the right time or for a long enough period. Another question might be whether the Ca2+-dependent release of glutamate is the correct target for improving outcomes following surgical decompression. Future research should focus on understanding the metabolic changes occurring over the course of degenerative cervical myelopathy, which might reveal targets for medical treatment. Ideally, a factor could be discovered that predicts the development of degenerative cervical myelopathy and provides a way to prevent symptom onset by promoting early treatment.