New medical procedure more efficient, fewer side effects

By Noah Grand
Daily Bruin Contributor

A new medical procedure developed by UCLA neurosurgeon Dr. Aaron
Filler and colleagues will allow doctors to deliver medicine
through the nerves to specific parts of the body.

Such a procedure allows doctors to use less drugs that have the
same effect while avoiding unwanted side effects.

“The way this works makes this the first 21st century
medication,” Filler said. “There are a number of
medical effects that can’t be done before this
process.”

Filler’s process uses a new combination of molecules to
deliver medicine by which the molecules are able to target specific
areas of the body by going through the nerves.

Carrying medicine through the nerves reduces side effects
because less medicine is needed to relieve a patient’s
pain.

This new procedure is the first to carry medicine through the
nerves.

The only similar way to deliver medicine without side effects is
through the spinal fluid, but that requires surgery.

Normally, medication goes into the bloodstream, which transports
the medicine to all parts of the body.

During surgery, medicine delivered through the blood can cause
side effects such as nausea and drowsiness because of the high
amounts used.

“There are many medicines that are effective in reducing
pain, but by the time that a large enough dose has been
administered to be effective, you have side effects,” said
Dr. Joshua Prager, director of the California Pain Medicine
Center.

“We try to deliver the optimal amount of medicine without
side effects,” he added.

The new delivery system can reduce the amount of an opiate, such
as morphine, needed to effectively reduce a patient’s pain to
one thousandth of the normal dose, according to Filler.

Transporting medicine through the nerves may be cheaper than
delivering medicine through spinal fluid.

“I use expensive devices and surgery to deliver medicine
to the spinal fluid,” Prager said. “Dr. Filler goes up
the nerve fibers.”

The advance of Filler’s procedure is that it is an
injection and does not require surgery or complicated machines.

“We inject the drug before surgery, and it should relieve
pain for four days with no side effects,” said Filler.

Human testing of the procedure will not start until 2002. Filler
said this time frame was typical with a new procedure.

Besides pain relief before surgery, Filler said the process
could be used to send medicine to the motor nerves to relieve
muscle spasms.

Because the medicine goes to the brain itself, the process could
also be used to treat multiple sclerosis or Alzheimer’s
disease in the future.

Filler’s process is the first one capable of delivering
medicine specifically to the nerves in the brain affected by these
diseases.

“This could lead to 50 or 60 new medicines over the next
10 years,” Filler said.

He has worked on this process for 20 years after he discovered
some of the base ideas as a graduate student in the late
’70s.

The discovery was only completed now because the technology to
make molecules that carry medicine through the nerves by a natural
process called axonal transport was recently developed.

“Axonal transport has been the subject of 20 to 30
thousand papers in the last 30 years,” Filler said.

Filler, however, is the first to use the system for medical
purposes.