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在健康受试者中使用一系列疼痛模型未检测到选择性Na 1.7抑制剂PF-05089771的镇痛特性。

Lack of Detection of the Analgesic Properties of PF-05089771, a Selective Na 1.7 Inhibitor, Using a Battery of Pain Models in Healthy Subjects.

作者信息

Siebenga Pieter, van Amerongen Guido, Hay Justin L, McDonnell Aoibhinn, Gorman Donal, Butt Richard, Groeneveld Geert Jan

机构信息

Centre for Human Drug Research, Leiden, The Netherlands.

Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK.

出版信息

Clin Transl Sci. 2020 Mar;13(2):318-324. doi: 10.1111/cts.12712. Epub 2019 Nov 12.

Abstract

Sodium channel blockers are used for the treatment of pain, but this is limited by the lack of selectivity for different sodium channel subtypes, which can result in central nervous system and cardiovascular side effects. As such, there is special interest in the Na 1.7 subtype, which is expressed predominantly in nociceptive and sympathetic neurons. The aim was to demonstrate analgesic properties of a potent selective Na 1.7 sodium channel blocker, PF-05089771, alone and concomitantly with pregabalin in healthy subjects using a battery of human evoked pain models. This was a double-blind, double-dummy, randomized, placebo-controlled, five-period cross-over study with PF-05089771 alone and PF-05089771 concomitantly with pregabalin as treatment arms with pregabalin, ibuprofen, and placebo as control arms (NCT02349607). A battery of human evoked pain models was used to investigate analgesic properties of PF-05089771. Twenty-five subjects were enrolled in the study of which 23 subjects completed all five periods. PF-05089771 alone did not differ from placebo on the primary pain end points. The same holds when comparing PF-05089771 concomitantly with pregabalin and pregabalin alone. Pregabalin showed significant effects relative to placebo on thermal pain on the normal skin and UVB skin (least squares means with 90% confidence interval: 0.63 (0.32-0.93) and 0.53 (0.11-0.96)), pressure stimulation (1.10 (1.04-1.18)), and cold pressor (1.22 (1.14-1.32)). Ibuprofen demonstrated significant effects on thermal pain UVB skin (1.26 (0.82-1.70)) and pressure stimulation assessment (1.08 (1.01-1.15)), consistent with historical results. This study did not demonstrate analgesic properties of PF-05089771 alone or concomitantly with pregabalin in a battery of pain models.

摘要

钠通道阻滞剂用于治疗疼痛,但由于对不同钠通道亚型缺乏选择性,其应用受到限制,这可能导致中枢神经系统和心血管方面的副作用。因此,人们对主要在伤害性和交感神经元中表达的Na 1.7亚型特别感兴趣。目的是使用一系列人体诱发疼痛模型,在健康受试者中证明一种强效选择性Na 1.7钠通道阻滞剂PF-05089771单独使用以及与普瑞巴林联合使用时的镇痛特性。这是一项双盲、双模拟、随机、安慰剂对照、五周期交叉研究,以单独使用PF-05089771以及PF-05089771与普瑞巴林联合使用作为治疗组,以普瑞巴林、布洛芬和安慰剂作为对照组(NCT02349607)。使用一系列人体诱发疼痛模型来研究PF-05089771的镇痛特性。25名受试者参与了该研究,其中23名受试者完成了所有五个周期。单独使用PF-05089771在主要疼痛终点上与安慰剂没有差异。将PF-05089771与普瑞巴林联合使用和单独使用普瑞巴林进行比较时也是如此。与安慰剂相比,普瑞巴林在正常皮肤和紫外线B照射皮肤的热痛方面显示出显著效果(最小二乘均值及90%置信区间:0.63(0.32 - 0.93)和0.53(0.11 - 0.96))、压力刺激(1.10(1.04 - 1.18))以及冷加压试验(1.22( ).14 - 1.32))。布洛芬在紫外线B照射皮肤的热痛(1.26(0.82 - 1.70))和压力刺激评估(1.08(1.01 - 1.15))方面显示出显著效果,与既往结果一致。该研究未证明PF-05089771单独使用或与普瑞巴林联合使用在一系列疼痛模型中的镇痛特性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/548b/7070789/062b9ae80601/CTS-13-318-g001.jpg

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