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检测镇痛药物药效的人体诱发疼痛模型组合的可重复性。

Reproducibility of a battery of human evoked pain models to detect pharmacological effects of analgesic drugs.

机构信息

Centre for Human Drug Research, Leiden, The Netherlands.

Pfizer Inc., Cambridge, Massachusetts.

出版信息

Eur J Pain. 2019 Jul;23(6):1129-1140. doi: 10.1002/ejp.1379. Epub 2019 Apr 5.

Abstract

BACKGROUND

Although reproducibility is considered essential for any method used in scientific research, it is investigated only rarely; thus, strikingly little has been published regarding the reproducibility of evoked pain models involving human subjects. Here, we studied the reproducibility of a battery of evoked pain models for demonstrating the analgesic effects of two analgesic compounds.

METHODS

A total of 81 healthy subjects participated in four studies involving a battery of evoked pain tests in which mechanical, thermal and electrical stimuli were used to measure pain detection and tolerance thresholds. Pharmacodynamic outcome variables were analysed using a mixed model analysis of variance, and a coefficient of variation was calculated by dividing the standard deviation by the least squares means.

RESULTS

A total of 76 subjects completed the studies. After being administered pregabalin, the subjects' pain tolerance thresholds in the cold pressor and pressure stimulation tests were significantly increased compared to the placebo group. Moreover, the heat pain detection threshold in UVB-irradiated skin was significantly increased in subjects who were administered ibuprofen compared to the placebo group. Variation among all evoked pain tests ranged from 2.2% to 30.6%.

CONCLUSIONS

Four studies using a similar design showed reproducibility with respect to the included evoked pain models. The relatively high consistency and reproducibility of two analgesics at doses known to be effective in treating clinically relevant pain supports the validity of using this pain test battery to investigate the analgesic activity and determine the active dosage of putative analgesic compounds in early clinical development.

SIGNIFICANCE

The consistency and reproducibility of measuring the profile of an analgesic at clinically relevant doses illustrates that this pain test battery is a valid tool for demonstrating the analgesic activity of a test compound and for determining the optimal active dose in early clinical drug development.

摘要

背景

尽管可重复性被认为是任何科学研究方法所必需的,但它很少被研究;因此,关于涉及人体受试者的诱发疼痛模型的可重复性,发表的内容少得惊人。在这里,我们研究了一系列诱发疼痛模型的可重复性,以证明两种镇痛化合物的镇痛效果。

方法

共有 81 名健康受试者参加了四项研究,这些研究涉及一系列诱发疼痛测试,其中使用机械、热和电刺激来测量疼痛检测和耐受阈值。使用混合模型方差分析分析药效学结果变量,并通过将标准差除以最小二乘均值来计算变异系数。

结果

共有 76 名受试者完成了这些研究。与安慰剂组相比,给予普瑞巴林后,冷加压和压力刺激试验中受试者的疼痛耐受阈值显著增加。此外,与安慰剂组相比,给予布洛芬的受试者在紫外线照射皮肤中的热痛觉检测阈值显著增加。所有诱发疼痛测试的变异性范围为 2.2%至 30.6%。

结论

四项使用类似设计的研究表明,所包括的诱发疼痛模型具有可重复性。两种镇痛药在已知治疗临床相关疼痛的有效剂量下的相对较高一致性和可重复性支持使用这种疼痛测试组合来研究镇痛活性并确定早期临床开发中潜在镇痛化合物的有效剂量的有效性。

意义

在临床相关剂量下测量镇痛剂特征的一致性和可重复性表明,这种疼痛测试组合是一种有效的工具,可以证明测试化合物的镇痛活性,并确定早期临床药物开发中的最佳有效剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f335/6618124/c1a06d7245cb/EJP-23-1129-g001.jpg

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