Chen Eric Y, Beutler Sascha S, Kaye Alan D, Edinoff Amber N, Khademi Seyed-Hossein, Stoltz Andrea E, Rueb Nicole R, Cornett Elyse M, Suh Winston J
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, USA.
Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, USA.
Anesth Pain Med. 2021 Dec 22;11(6):e121402. doi: 10.5812/aapm.121402. eCollection 2021 Dec.
Neuropathic pain is a challenge for physicians to treat and often requires a multimodal approach with both pharmacologic and lifestyle interventions. Mirogabalin, a potent, selective ligand of the α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs), provides analgesia by inhibiting neurotransmitter release at the presynaptic end of the neuron. Mirogabalin offers more sustained analgesia than its gabapentinoid counterparts in addition to a wider safety margin for adverse events. Recent clinical trials of mirogabalin have demonstrated both efficacy and tolerability of the drug for the treatment of diabetic peripheral neuropathic pain and postherpetic neuralgia, leading to its approval in Japan. While still not yet FDA approved, mirogabalin is still in its infancy and offers potential into the treatment of neuropathic pain and its associated comorbidities.
神经性疼痛对医生来说是一个治疗挑战,通常需要药物和生活方式干预相结合的多模式方法。米罗加巴林是一种强效、选择性的电压门控钙通道(VGCCs)α2δ-1和α2δ-2亚基配体,通过抑制神经元突触前末端的神经递质释放来提供镇痛作用。与同类加巴喷丁类药物相比,米罗加巴林具有更持久的镇痛效果,且不良事件的安全边际更宽。米罗加巴林最近的临床试验已证明该药物在治疗糖尿病性周围神经病变性疼痛和带状疱疹后神经痛方面的有效性和耐受性,从而使其在日本获得批准。虽然米罗加巴林尚未获得美国食品药品监督管理局(FDA)批准,但仍处于起步阶段,为神经性疼痛及其相关合并症的治疗提供了潜力。