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Ziconotida para el tratamiento del dolor crónico severo
Achim Schmidtko1, Jörn Lötsch, Rainer Freynhagen
1Pharmazentrum Frankfurt/ZAFES, Institut für Klinische Pharmakologie, Goethe-Universität, Frankfurt am Main, Germany.
Lancet (London, England)
|April 24, 2010
Resumen
La ziconotida ofrece un nuevo enfoque para el dolor crónico severo mediante el bloqueo de canales de calcio específicos. Sin embargo, su estrecha ventana terapéutica y los efectos secundarios limitan su uso a un pequeño grupo de pacientes.
Área de la Ciencia:
- Farmacología Farmacología.
- La neurociencia es la neurociencia.
- Manejo del dolor Manejo del dolor.
Sus antecedentes:
- El manejo del dolor crónico severo presenta importantes necesidades terapéuticas no satisfechas.
- Los analgésicos actuales a menudo no proporcionan un alivio adecuado para el dolor refractario.
- El ziconotido intratecal representa una nueva opción terapéutica para estos casos.
Objetivo del estudio:
- Para proporcionar una visión general del tratamiento intratecal con ziconotida.
- Revisar los beneficios y limitaciones de la terapia con ziconotida.
- Para discutir los desarrollos futuros en bloqueadores de los canales de calcio tipo N.
Principales métodos:
- Revisión de la literatura existente sobre el ziconotide.
- Análisis del mecanismo farmacológico de acción de la ziconotida.
- Evaluación de los datos clínicos sobre la eficacia y los efectos secundarios.
Principales resultados:
- Ziconotide es el primer bloqueador selectivo de los canales de calcio del tipo N sensible a la tensión aprobado para uso intratecal.
- Inhibe la liberación de neurotransmisores en la médula espinal, reduciendo el dolor.
- La ziconotida tiene una ventana terapéutica estrecha debido a los efectos secundarios del sistema nervioso central.
Conclusiones:
- La ziconotida intratecal es eficaz para el dolor crónico severo y refractario.
- Su uso está limitado a un subconjunto de pacientes debido a los efectos secundarios.
- La investigación adicional en esta clase de fármacos puede dar lugar a terapias mejoradas.
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