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一项评估高度选择性钠离子通道 1.8 型抑制剂 VX-150 在健康男性成年人中药效学影响的 1 期、随机、双盲、安慰剂对照、交叉研究。

A Phase 1, Randomized, Double-Blind, Placebo-Controlled, Crossover Study to Evaluate the Pharmacodynamic Effects of VX-150, a Highly Selective NaV1.8 Inhibitor, in Healthy Male Adults.

机构信息

Centre for Human Drug Research, Leiden, The Netherlands.

Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Pain Med. 2021 Aug 6;22(8):1814-1826. doi: 10.1093/pm/pnab032.

Abstract

OBJECTIVE

To evaluate the analgesic potential, safety, tolerability, and pharmacokinetics of VX-150, a pro-drug of a highly selective NaV1.8 inhibitor, in healthy subjects.

DESIGN

This was a randomized, double-blind, placebo-controlled, crossover study in healthy subjects.

SUBJECTS

Twenty healthy male subjects with an age of 18-55 years, inclusive, were enrolled. Eligibility was based on general fitness, absence of current or previous medical conditions that could compromise subject safety, and a training assessment of pain tolerance across pain tests to exclude highly tolerant individuals whose tolerance could compromise the ability to detect analgesic responses. All dosed subjects completed the study.

METHODS

Subjects were randomized 1:1 to one of two sequences receiving a single VX-150 dose and subsequently placebo, or vice versa, with at least 7 days between dosing. A battery of pain tests (pressure, electrical stair, [capsaicin-induced] heat, and cold pressor) was administered before dosing and repetitively up to 10 h after dosing, with blood sampling up to 24 h after dosing. Safety was monitored throughout the study. Data were analyzed with a repeated-measures mixed-effects model.

RESULTS

VX-150 induced analgesia in a variety of evoked pain tests, without affecting subject safety. Significant effects were reported for the cold pressor and heat pain thresholds. Maximum median concentration for the active moiety was 4.30 µg/mL at 4 h after dosing.

CONCLUSION

Results of this proof-of-mechanism study are supportive of the potential of VX-150, a highly selective NaV1.8 channel inhibitor, to treat various pain indications.

摘要

目的

评估 VX-150(一种高度选择性 NaV1.8 抑制剂的前药)在健康受试者中的镇痛潜力、安全性、耐受性和药代动力学。

设计

这是一项在健康受试者中进行的随机、双盲、安慰剂对照、交叉研究。

受试者

共纳入 20 名年龄在 18-55 岁之间的健康男性受试者。入选标准基于一般健康状况、无当前或既往可能影响受试者安全的疾病,以及疼痛耐受测试中的疼痛耐受培训评估,以排除疼痛耐受程度高的个体,因为这些个体的高耐受程度可能会影响到检测镇痛反应的能力。所有接受给药的受试者均完成了研究。

方法

受试者按照 1:1 的比例随机分为两组,一组接受单次 VX-150 剂量,随后给予安慰剂,另一组则相反,两组之间至少间隔 7 天。在给药前和给药后最多 10 小时内进行一系列疼痛测试(压力、电阶梯、[辣椒素诱导]热和冷加压),并在给药后最多 24 小时内进行血液采样。在整个研究过程中监测安全性。数据采用重复测量混合效应模型进行分析。

结果

VX-150 诱导了多种诱发疼痛测试的镇痛作用,同时不影响受试者的安全性。冷加压和热痛阈值有显著影响。活性物质的最大中位数浓度在给药后 4 小时达到 4.30 µg/mL。

结论

这项机制验证研究的结果支持 VX-150(一种高度选择性 NaV1.8 通道抑制剂)作为治疗各种疼痛适应症的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71ec/8346919/dd589ba65825/pnab032f1.jpg

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