telmisartan + metformin + cilostazol

The combination of telmisartan, metformin, and cilostazol is an investigational triple-drug pharmacotherapy being developed by Neuro-Innovators in collaboration with Spaulding Rehabilitation Hospital. This combination is designed to enhance motor gains in chronic ischemic stroke survivors undergoing robot-assisted upper-extremity rehabilitation. The therapy consists of three small molecule active ingredients: telmisartan (an angiotensin II receptor blocker), metformin (a biguanide antidiabetic agent), and cilostazol (a phosphodiesterase-3 inhibitor with antiplatelet and vasodilatory properties). The development strategy follows the FDA's 505(b)(2) regulatory pathway, targeting a patient population with no current standard of care for chronic stroke recovery. The combination aims to leverage the neuroprotective and neuroplasticity-enhancing effects of its components to improve functional outcomes as measured by the Fugl-Meyer scale.