-Four out of 10 people have suppression due to gacyclidine. So 60% did not.
-Long term administration of the drug is needed. How long?
-Short and long term safety effects.
The study you are referring to is the Wenzel study. It was a study put in place for compassionate help to a limited number of patients (10 or so). The patients were (probably) not chosen for their patient profile (from a tinnitus perspective), but, instead due to their suffering (all were deaf, unilaterally). The fact that they were deaf meant there was no risk from the intervention which required direct access to the round window membrane (i.e. should the inner ear perilympathic liquid spill out, they would have nothing to lose as they were deaf already). So in a sense, the patient profile was: mitigation of risk first, tinnitus profile ideology second.
However, by being unilaterally deaf already well before the intervention, probably most/all patients were chronic sufferers. High doses of Gacyclidine were given under ideal conditions (as the physicians had direct access to the inner ear). As the study was done on a compassionate basis, it probably did not set out to prove anything: it was just that - a study - capturing what did (or did not) happen to the 10 patients.
From a researcher I correspond with frequently:
In general, the acute phase is totally different from the chronic state. This is true for many - if not all - neurological diseases. E.g. in some diseases, there is an inflammation going on in the brain and if you are able to stop it, everything is solved. Another mechanisms is the excitotoxicity which is kind of cascade of dying neurons due to overstimulation. NMDA antagonists are considered to stop the cascade. This can be a quick process, if it works.
I have no specific knowledge of OTO-311 (other than that which I have posted within this thread), but I suspect that OTO-311 will not deliver the same amount of Gacyclidine to the inner ear that the Wenzel study did. But then again, the patient profile means everything (i.e. acute vs. chronic patients; see quote above). Of course, OTO-311 may deliver Gacylidine to the inner ear over a longer period of time (as opposed to a short high dosage intervention). Certainly, OTO-311 and the inner ear compounds of Otonomy are "patient friendly" requiring just one puncture to the tympanic membrane.
Anyway, we can speculate all day long. In the end, only results matter, and that is exactly what a clinical trial sets out to do.
attheedgeofscience
24/JAN/2016