1
|
Aramini A, Bianchini G, Lillini S, Tomassetti M, Pacchiarotti N, Canestrari D, Cocchiaro P, Novelli R, Dragani MC, Palmerio F, Mattioli S, Bordignon S, d'Angelo M, Castelli V, d'Egidio F, Maione S, Luongo L, Boccella S, Cimini A, Brandolini L, Chierotti MR, Allegretti M. Ketoprofen, lysine and gabapentin co-crystal magnifies synergistic efficacy and tolerability of the constituent drugs: Pre-clinical evidences towards an innovative therapeutic approach for neuroinflammatory pain. Biomed Pharmacother 2023; 163:114845. [PMID: 37167730 DOI: 10.1016/j.biopha.2023.114845] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/29/2023] [Accepted: 05/04/2023] [Indexed: 05/13/2023] Open
Abstract
Chronic pain is an enormous public health concern, and its treatment is still an unmet medical need. Starting from data highlighting the promising effects of some nonsteroidal anti-inflammatory drugs in combination with gabapentin in pain treatment, we sought to combine ketoprofen lysine salt (KLS) and gabapentin to obtain an effective multimodal therapeutic approach for chronic pain. Using relevant in vitro models, we first demonstrated that KLS and gabapentin have supra-additive effects in modulating key pathways in neuropathic pain and gastric mucosal damage. To leverage these supra-additive effects, we then chemically combined the two drugs via co-crystallization to yield a new compound, a ternary drug-drug co-crystal of ketoprofen, lysine and gabapentin (KLS-GABA co-crystal). Physicochemical, biodistribution and pharmacokinetic studies showed that within the co-crystal, ketoprofen reaches an increased gastrointestinal solubility and permeability, as well as a higher systemic exposure in vivo compared to KLS alone or in combination with gabapentin, while both the constituent drugs have increased central nervous system permeation. These unique characteristics led to striking, synergistic anti-nociceptive and anti-inflammatory effects of KLS-GABA co-crystal, as well as significantly reduced spinal neuroinflammation, in translational inflammatory and neuropathic pain rat models, suggesting that the synergistic therapeutic effects of the constituent drugs are further boosted by the co-crystallization. Notably, while strengthening the therapeutic effects of ketoprofen, KLS-GABA co-crystal showed remarkable gastrointestinal tolerability in both inflammatory and chronic neuropathic pain rat models. In conclusion, these results allow us to propose KLS-GABA co-crystal as a new drug candidate with high potential clinical benefit-to-risk ratio for chronic pain treatment.
Collapse
Affiliation(s)
- Andrea Aramini
- R&D, Dompé Farmaceutici S.p.A, Via Campo di Pilel, 67100 L'Aquila, Italy.
| | - Gianluca Bianchini
- R&D, Dompé Farmaceutici S.p.A, Via Campo di Pilel, 67100 L'Aquila, Italy
| | - Samuele Lillini
- R&D, Dompé Farmaceutici S.p.A, Via De Amicis, 80131 Naples, Italy
| | - Mara Tomassetti
- R&D, Dompé Farmaceutici S.p.A, Via De Amicis, 80131 Naples, Italy
| | | | - Daniele Canestrari
- R&D, Dompé Farmaceutici S.p.A, Via Campo di Pilel, 67100 L'Aquila, Italy
| | | | - Rubina Novelli
- R&D, Dompé Farmaceutici S.p.A, Via S. Lucia, 20122 Milan, Italy
| | | | | | - Simone Mattioli
- R&D, Dompé Farmaceutici S.p.A, Via De Amicis, 80131 Naples, Italy
| | - Simone Bordignon
- Department of Chemistry and NIS Centre, University of Torino, 10124 Torino, Italy
| | - Michele d'Angelo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Vanessa Castelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Francesco d'Egidio
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Sabatino Maione
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Livio Luongo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Serena Boccella
- R&D, Dompé Farmaceutici S.p.A, Via De Amicis, 80131 Naples, Italy
| | - Annamaria Cimini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy; Sbarro Institute for Cancer Research and Molecular Medicine and Center for Biotechnology, Temple University, Philadelphia, PA 19122, USA
| | - Laura Brandolini
- R&D, Dompé Farmaceutici S.p.A, Via Campo di Pilel, 67100 L'Aquila, Italy
| | | | | |
Collapse
|