Walicke Patricia A, Hefti Franz, Bales Roxanne, Lu Shiao-Ping, Ruckle Jon L, Brown Mark T, West Christine R, Shelton David L
Rinat Neuroscience (a subsidiary of Pfizer Inc), South San Francisco, CA, USA.
Radiant Research, Honolulu, HI, USA.
Pain Rep. 2018 May 9;3(3):e653. doi: 10.1097/PR9.0000000000000653. eCollection 2018 May.
The neurotrophin nerve growth factor has a demonstrated role in pain transduction and pathophysiology.
Two randomized, double-blind, placebo-controlled, phase 1 studies were conducted to evaluate safety, tolerability, and analgesic efficacy of single doses of tanezumab, a humanized anti-nerve growth factor monoclonal antibody, in chronic or acute pain.
In the first study (CL001), patients with moderate to severe pain from osteoarthritis (OA) of the knee received a single intravenous infusion of tanezumab (3-1000 μg/kg) or placebo in a dose-escalation (part 1; N = 42) or parallel-arm (part 2; N = 79) study design. The second study (CL002) was a placebo-controlled dose-escalation (tanezumab 10-1000 μg/kg; N = 50) study in patients undergoing bunionectomy surgery.
Adverse event rates were generally similar across treatments. Most adverse events were generally mild to moderate in severity and no patients discontinued as a result of adverse events. Adverse events of abnormal peripheral sensation were more common with higher doses of tanezumab (≥100 μg/kg) than with placebo. These were generally mild to moderate in severity. Tanezumab provided up to 12 weeks of effective analgesia for OA knee pain, with statistically significant improvements at doses ≥100 μg/kg ( < 0.05). By contrast, no trend for analgesic activity was found when tanezumab was administered 8 to 16 hours before bunionectomy.
The demonstration of a favorable safety profile and clinical efficacy in OA pain supports clinical development of tanezumab as a potential treatment for chronic pain conditions.
神经营养因子神经生长因子在疼痛传导和病理生理学中已显示出作用。
进行了两项随机、双盲、安慰剂对照的1期研究,以评估单剂量人源化抗神经生长因子单克隆抗体他尼珠单抗在慢性或急性疼痛中的安全性、耐受性和镇痛效果。
在第一项研究(CL001)中,中度至重度膝骨关节炎(OA)疼痛患者在剂量递增(第1部分;N = 42)或平行组(第2部分;N = 79)研究设计中接受单次静脉输注他尼珠单抗(3 - 1000μg/kg)或安慰剂。第二项研究(CL002)是一项在接受拇囊炎切除术的患者中进行的安慰剂对照剂量递增(他尼珠单抗10 - 1000μg/kg;N = 50)研究。
各治疗组的不良事件发生率总体相似。大多数不良事件的严重程度一般为轻度至中度,没有患者因不良事件而停药。高剂量(≥100μg/kg)他尼珠单抗比安慰剂更常出现外周感觉异常的不良事件。这些不良事件的严重程度一般为轻度至中度。他尼珠单抗为膝OA疼痛提供了长达12周的有效镇痛,在≥100μg/kg剂量时具有统计学显著改善(<0.05)。相比之下,在拇囊炎切除术8至16小时前给予他尼珠单抗时未发现镇痛活性趋势。
他尼珠单抗在OA疼痛中具有良好的安全性和临床疗效,支持其作为慢性疼痛疾病潜在治疗方法的临床开发。