针对慢性原发性疼痛药物开发的新方法:系统性审查
Valéria Tékus1,2, Éva Borbély1, Andreas Goebel3,4
1Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary.
British journal of pharmacology
|November 15, 2025
概括
慢性原发性疼痛 (CPP) 治疗由于复杂的机制和患者异质性而缺乏突破. 研究重点是新的目标和重定向药物,大麻素和 (es) 基他胺在像纤维肌痛这样的疾病中显示出希望.
科学领域:
- 疼痛医学 医学 疼痛医学
- 临床药理学 临床药理学
- 翻译研究是翻译研究.
背景情况:
- 慢性原发性疼痛 (CPP) 影响数以百万计的人,造成严重的痛苦和未满足的医疗需求.
- 目前的止痛药对相当一部分患者提供有限的缓解.
- 纤维肌痛,复杂区域性疼痛综合征和慢性腰部疼痛是关键的肌肉骨性CPP疾病.
研究的目的:
- 系统地审查临床试验 (第一至第三阶段) 针对新药开发和CPP中的重新用途.
- 确定广泛和区域肌肉骨性CPP的有前途的治疗点和治疗方法.
- 评估CPP药物治疗的进展和挑战.
主要方法:
- 来自主要数据库 (clinicaltrials.gov,欧盟临床试验注册,PubMed) 的临床试验的系统审查 (2014年1月 - 2024年7月).
- 专注于原始药物开发和药物重新定位用于纤维肌痛,复杂区域疼痛综合征和慢性腰部疼痛.
- 针对创新途径 (例如TRPA1,P2X7,SST4) 和重新定位的药物 (抗抑郁药,抗药,迷幻药,免疫调节剂) 的试验分析.
主要成果:
- 在CPP条件下没有报告显著的药物疗法突破.
- 挑战包括了解病理生理学,识别新型点,解决患者异质性和并发症.
- 有前途的治疗途径包括向大麻素,谷氨酸,GABAergic,神经炎症和免疫机制.
- 大麻素 (CBD) 和 (es) 胺已在所有三个研究的CPP条件中进行了调查.
结论:
- 尽管进行了广泛的研究,但CPP的药物治疗仍然具有挑战性.
- 患者群体的异质性和缺乏可翻译的临床前模型阻碍了进展.
- 针对特定的途径,如大麻素和免疫机制,以及重新定位的药物,如CBD和 (es) ketamine,显示了未来CPP治疗的潜力.
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