Arsenault Pierre, Chiche Dan, Brown William, Miller Jeffrey, Treister Roi, Leff Richard, Walker Philippe, Katz Nathaniel
Diex Recherche Sherbrooke, Sherbrooke, QC, Canada.
NEOMED Institute, Montreal, QC, Canada.
Pain Rep. 2018 Oct 26;3(6):e696. doi: 10.1097/PR9.0000000000000696. eCollection 2018 Nov.
NEO6860 is a TRPV1 antagonist when activated by capsaicin but not by heat or pH, developed to relieve pain without the adverse events reported with non-modality-selective TRPV1 antagonists.
The primary Objective of this study was to evaluate the analgesic efficacy and safety of NEO6860 after 1 day oral dosing in patients with Kellgren-Lawrence stage I, II or III osteoarthritis of the knee.
This randomized, double-blinded, 3-period crossover, phase II study compared 1 day (2 doses) of NEO6860 (500 mg twice a day), placebo, and naproxen in 54 patients with osteoarthritis knee pain. Primary endpoint was reduction in pain intensity (PI) on Numerical Rating Scale after exercise, using the staircase test, 8 hours after dose.
Level of PI, compared with baseline, was numerically lower during NEO6860 and naproxen periods vs placebo at 3 and 24 hours, but not at 8 hours after first dose. A statistically significant effect for naproxen and a trend for NEO6860 were observed at 3 and 24 hours. Least square means' (95% confidence interval) change in PI at 24 hours was -0.67 (-1.09 to -0.26), -0.97 (-1.39 to -0.55), -0.29 (-0.71 to 0.13) for NEO6860, naproxen, and placebo, respectively. NEO6860 exposure was ∼1.6 times higher compared with previous phase I. In this study, NEO6860 safety profile was less favorable than naproxen or placebo. Possibly NEO6860-related adverse events included: feel hot, headache, nausea, dizziness, fatigue, hypoaesthesia, and increased blood pressure.
In this exploratory study, NEO6860 did not statistically significantly outperform placebo but showed an analgesic trend, without impacting body temperature and heat pain perception. Further studies are warranted to explore the potential of NEO6860 in other pain indications. We intent to optimize the dose and evaluate analgesic synergism with other mechanism.
NEO6860是一种辣椒素激活而非热或pH激活的瞬时受体电位香草酸亚型1(TRPV1)拮抗剂,其研发目的是缓解疼痛,且无非模式选择性TRPV1拮抗剂所报告的不良事件。
本研究的主要目的是评估NEO6860在口服给药1天后,对凯尔格伦-劳伦斯(Kellgren-Lawrence)I、II或III期膝骨关节炎患者的镇痛疗效和安全性。
这项随机、双盲、3期交叉II期研究,在54例膝骨关节炎疼痛患者中比较了NEO6860(500毫克,每日两次)、安慰剂和萘普生1天(2剂)的效果。主要终点是在剂量后8小时,使用阶梯试验,运动后数字评分量表上疼痛强度(PI)的降低。
与基线相比,在第3和24小时,NEO6860和萘普生治疗期间的PI数值低于安慰剂组,但在首次给药后8小时并非如此。在第3和24小时观察到萘普生具有统计学显著效果,NEO6860有一定趋势。24小时时,NEO6860、萘普生和安慰剂的PI最小二乘均值(95%置信区间)变化分别为-0.67(-1.09至-0.26)、-0.97(-1.39至-0.55)、-0.29(-0.71至0.13)。与之前的I期相比,NEO6860的暴露量高出约1.6倍。在本研究中,NEO6860的安全性不如萘普生或安慰剂。可能与NEO6860相关的不良事件包括:感觉发热、头痛、恶心、头晕、疲劳、感觉减退和血压升高。
在这项探索性研究中,NEO6860在统计学上没有显著优于安慰剂,但显示出镇痛趋势,且不影响体温和热痛觉。有必要进一步研究探索NEO6860在其他疼痛适应症中的潜力。我们打算优化剂量,并评估与其他机制的镇痛协同作用。