Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Fruit St, Boston, MA, 02114, USA.
Louisiana Addiction Research Center, Shreveport, LA, 71103, USA.
Curr Pain Headache Rep. 2023 Oct;27(10):615-622. doi: 10.1007/s11916-023-01148-9. Epub 2023 Aug 9.
Regardless of the etiology, if pain persists chronically, it can detrimentally impact multiple aspects of a patient's well-being. Both physical and psychological effects are significant in many chronic pain patients. In this regard, psychological consequences can alter a patient's quality of life, functionality, and social functioning. Opioids have been the long-established gold standard for acute pain treatment in settings such as the postoperative period. An alternative to opioids in pain management has been highly sought after. Through a non-selective mechanism, cebranopadol is a first-in-class oral drug which combines agonism of the mu and nociceptin opioid peptide (NOP) receptors to provide improved analgesia, while reducing the occurrence of many typically opioid side effects. This manuscript is a narrative review of the possible use of cebranopadol in pain management.
In pre-clinical studies, cebranopadol was similar to morphine in its pain control efficacy. In a phase IIa trial, cebranopadol was superior to placebo in reducing pain. In a randomized clinical trial, cebranopadol was superior to morphine. Another study concluded that cebranopadol had a lower misuse potential when compared to hydromorphone. In summary, cebranopadol offers new opportunities in treating chronic moderate to severe pain, while also countering risks of addiction. Additional studies are warranted to further evaluate the safety and efficacy of cebranopadol. In this regard, cebranopadol could prove to be a promising alternative to current pain treatment options.
无论病因如何,如果疼痛持续存在,都会对患者的身心健康造成多方面的不利影响。许多慢性疼痛患者都存在明显的躯体和心理影响。在这种情况下,心理后果会改变患者的生活质量、功能和社交功能。阿片类药物一直是术后等情况下急性疼痛治疗的既定金标准。因此,人们一直在寻找疼痛管理的阿片类药物替代药物。塞来诺啡是一种具有全新作用机制的口服药物,通过非选择性机制,它同时激动 μ 型阿片受体和孤啡肽(NOP)受体,从而提供更好的镇痛效果,同时减少许多常见的阿片类药物副作用。本文是一篇关于塞来诺啡在疼痛管理中应用的综述。
在临床前研究中,塞来诺啡在控制疼痛方面与吗啡相似。在一项 2 期临床试验中,塞来诺啡在减轻疼痛方面优于安慰剂。在一项随机临床试验中,塞来诺啡优于吗啡。另一项研究得出结论,与氢吗啡酮相比,塞来诺啡的滥用潜力较低。总之,塞来诺啡为治疗慢性中重度疼痛提供了新的机会,同时也降低了成瘾的风险。需要进一步的研究来进一步评估塞来诺啡的安全性和疗效。在这方面,塞来诺啡可能成为当前疼痛治疗选择的一种有前途的替代药物。