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Hijma H, Koopmans I, Klaassen E, Doll RJ, Zuiker R, Groeneveld GJ. A crossover study evaluating the sex-dependent and sensitizing effects of sleep deprivation using a nociceptive test battery in healthy subjects. Br J Clin Pharmacol 2023; 89:361-371. [PMID: 35997713 PMCID: PMC10086808 DOI: 10.1111/bcp.15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/21/2022] [Accepted: 08/04/2022] [Indexed: 12/01/2022] Open
Abstract
AIM We assessed whether total sleep deprivation (TSD) in combination with pain tests yields a reliable method to assess altered pain thresholds, which subsequently may be used to investigate (novel) analgesics in healthy subjects. METHODS This was a two-part randomized crossover study in 24 healthy men and 24 women. Subjects were randomized 1:1 to first complete a day of nonsleep-deprived nociceptive threshold testing, followed directly by a TSD night and morning of sleep-deprived testing, or first complete the TSD night and morning sleep-deprived testing, returning 7 days later for a day of nonsleep-deprived testing. A validated pain test battery (heat, pressure, electrical burst and stair, cold pressor pain test and conditioned pain modulation [CPM] paradigm) and sleep questionnaires were performed. RESULTS Subjects were significantly sleepier after TSD as measured using sleepiness questionnaires. Cold pressor pain tolerance (PTT, estimate of difference [ED] -10.8%, 95% CI -17.5 to -3.6%), CPM PTT (ED -0.69 mA, 95% CI -1.36 to -0.03 mA), pressure PTT (ED -11.2%, 95% CI -17.5% to -4.3%) and heat pain detection thresholds (ED -0.74 °C, 95% CI -1.34 to -0.14 °C) were significantly decreased after TSD compared to the baseline morning assessment in the combined analysis (men + women). Heat hyperalgesia was primarily driven by an effect of TSD in men, whereas cold and pressure hyperalgesia was primarily driven by the effects of TSD observed in women. CONCLUSIONS TSD induced sex-dependent hyperalgesia on cold, heat and pressure pain, and CPM response. These results suggest that the TSD model may be suitable to evaluate (novel) analgesics in early-phase drug studies.
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Affiliation(s)
- Hemme Hijma
- Centre for Human Drug Research, CL, Leiden, The Netherlands.,Leiden University Medical Centre, ZA, Leiden, The Netherlands
| | - Ingrid Koopmans
- Centre for Human Drug Research, CL, Leiden, The Netherlands.,Leiden University Medical Centre, ZA, Leiden, The Netherlands
| | - Erica Klaassen
- Centre for Human Drug Research, CL, Leiden, The Netherlands
| | | | - Rob Zuiker
- Centre for Human Drug Research, CL, Leiden, The Netherlands
| | - Geert Jan Groeneveld
- Centre for Human Drug Research, CL, Leiden, The Netherlands.,Leiden University Medical Centre, ZA, Leiden, The Netherlands
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2
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Hijma HJ, Siebenga PS, de Kam ML, Groeneveld GJ. A Phase 1, Randomized, Double-Blind, Placebo-Controlled, Crossover Study to Evaluate the Pharmacodynamic Effects of VX-150, a Highly Selective NaV1.8 Inhibitor, in Healthy Male Adults. PAIN MEDICINE 2021; 22:1814-1826. [PMID: 33543763 PMCID: PMC8346919 DOI: 10.1093/pm/pnab032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective To evaluate the analgesic potential, safety, tolerability, and pharmacokinetics of VX-150, a pro-drug of a highly selective NaV1.8 inhibitor, in healthy subjects. Design This was a randomized, double-blind, placebo-controlled, crossover study in healthy subjects. Subjects Twenty healthy male subjects with an age of 18–55 years, inclusive, were enrolled. Eligibility was based on general fitness, absence of current or previous medical conditions that could compromise subject safety, and a training assessment of pain tolerance across pain tests to exclude highly tolerant individuals whose tolerance could compromise the ability to detect analgesic responses. All dosed subjects completed the study. Methods Subjects were randomized 1:1 to one of two sequences receiving a single VX-150 dose and subsequently placebo, or vice versa, with at least 7 days between dosing. A battery of pain tests (pressure, electrical stair, [capsaicin-induced] heat, and cold pressor) was administered before dosing and repetitively up to 10 h after dosing, with blood sampling up to 24 h after dosing. Safety was monitored throughout the study. Data were analyzed with a repeated-measures mixed-effects model. Results VX-150 induced analgesia in a variety of evoked pain tests, without affecting subject safety. Significant effects were reported for the cold pressor and heat pain thresholds. Maximum median concentration for the active moiety was 4.30 µg/mL at 4 h after dosing. Conclusion Results of this proof-of-mechanism study are supportive of the potential of VX-150, a highly selective NaV1.8 channel inhibitor, to treat various pain indications.
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Affiliation(s)
- Hemme J Hijma
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | - Pieter S Siebenga
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | | | - Geert Jan Groeneveld
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
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3
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Siebenga P, van Amerongen G, Hay JL, McDonnell A, Gorman D, Butt R, Groeneveld GJ. Lack of Detection of the Analgesic Properties of PF-05089771, a Selective Na v 1.7 Inhibitor, Using a Battery of Pain Models in Healthy Subjects. Clin Transl Sci 2019; 13:318-324. [PMID: 31642607 PMCID: PMC7070789 DOI: 10.1111/cts.12712] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022] Open
Abstract
Sodium channel blockers are used for the treatment of pain, but this is limited by the lack of selectivity for different sodium channel subtypes, which can result in central nervous system and cardiovascular side effects. As such, there is special interest in the Nav 1.7 subtype, which is expressed predominantly in nociceptive and sympathetic neurons. The aim was to demonstrate analgesic properties of a potent selective Nav 1.7 sodium channel blocker, PF-05089771, alone and concomitantly with pregabalin in healthy subjects using a battery of human evoked pain models. This was a double-blind, double-dummy, randomized, placebo-controlled, five-period cross-over study with PF-05089771 alone and PF-05089771 concomitantly with pregabalin as treatment arms with pregabalin, ibuprofen, and placebo as control arms (NCT02349607). A battery of human evoked pain models was used to investigate analgesic properties of PF-05089771. Twenty-five subjects were enrolled in the study of which 23 subjects completed all five periods. PF-05089771 alone did not differ from placebo on the primary pain end points. The same holds when comparing PF-05089771 concomitantly with pregabalin and pregabalin alone. Pregabalin showed significant effects relative to placebo on thermal pain on the normal skin and UVB skin (least squares means with 90% confidence interval: 0.63 (0.32-0.93) and 0.53 (0.11-0.96)), pressure stimulation (1.10 (1.04-1.18)), and cold pressor (1.22 (1.14-1.32)). Ibuprofen demonstrated significant effects on thermal pain UVB skin (1.26 (0.82-1.70)) and pressure stimulation assessment (1.08 (1.01-1.15)), consistent with historical results. This study did not demonstrate analgesic properties of PF-05089771 alone or concomitantly with pregabalin in a battery of pain models.
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Affiliation(s)
| | | | - Justin L Hay
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | - Donal Gorman
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
| | - Richard Butt
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
| | - Geert Jan Groeneveld
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Centre, Leiden, The Netherlands
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4
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Siebenga PS, van Amerongen G, Okkerse P, Denney WS, Dua P, Butt RP, Hay JL, Groeneveld GJ. Reproducibility of a battery of human evoked pain models to detect pharmacological effects of analgesic drugs. Eur J Pain 2019; 23:1129-1140. [PMID: 30793411 PMCID: PMC6618124 DOI: 10.1002/ejp.1379] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/01/2019] [Accepted: 02/17/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although reproducibility is considered essential for any method used in scientific research, it is investigated only rarely; thus, strikingly little has been published regarding the reproducibility of evoked pain models involving human subjects. Here, we studied the reproducibility of a battery of evoked pain models for demonstrating the analgesic effects of two analgesic compounds. METHODS A total of 81 healthy subjects participated in four studies involving a battery of evoked pain tests in which mechanical, thermal and electrical stimuli were used to measure pain detection and tolerance thresholds. Pharmacodynamic outcome variables were analysed using a mixed model analysis of variance, and a coefficient of variation was calculated by dividing the standard deviation by the least squares means. RESULTS A total of 76 subjects completed the studies. After being administered pregabalin, the subjects' pain tolerance thresholds in the cold pressor and pressure stimulation tests were significantly increased compared to the placebo group. Moreover, the heat pain detection threshold in UVB-irradiated skin was significantly increased in subjects who were administered ibuprofen compared to the placebo group. Variation among all evoked pain tests ranged from 2.2% to 30.6%. CONCLUSIONS Four studies using a similar design showed reproducibility with respect to the included evoked pain models. The relatively high consistency and reproducibility of two analgesics at doses known to be effective in treating clinically relevant pain supports the validity of using this pain test battery to investigate the analgesic activity and determine the active dosage of putative analgesic compounds in early clinical development. SIGNIFICANCE The consistency and reproducibility of measuring the profile of an analgesic at clinically relevant doses illustrates that this pain test battery is a valid tool for demonstrating the analgesic activity of a test compound and for determining the optimal active dose in early clinical drug development.
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Affiliation(s)
| | | | | | - William S. Denney
- Pfizer Inc.CambridgeMassachusetts
- Present address:
Human Predictions LLCCambridgeMassachusetts
| | | | | | | | - Geert J. Groeneveld
- Centre for Human Drug ResearchLeidenThe Netherlands
- Leiden University Medical CenterLeidenThe Netherlands
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5
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Siebenga PS, van Amerongen G, Klaassen ES, de Kam ML, Rissmann R, Groeneveld GJ. The ultraviolet B inflammation model: Postinflammatory hyperpigmentation and validation of a reduced UVB exposure paradigm for inducing hyperalgesia in healthy subjects. Eur J Pain 2019; 23:874-883. [PMID: 30597682 PMCID: PMC6590423 DOI: 10.1002/ejp.1353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/17/2018] [Accepted: 12/23/2018] [Indexed: 12/18/2022]
Abstract
Background Pain models are commonly used in drug development to demonstrate analgesic activity in healthy subjects and should therefore not cause long‐term adverse effects. The ultraviolet B (UVB) model is a model for inflammatory pain in which three times the minimal erythema dose (3MED) is typically applied to induce sensitization. Based on reports of long‐lasting postinflammatory hyperpigmentation (PIH) associated with 3MED, it was decided to investigate the prevalence of PIH among subjects who were previously exposed to 3MED at our research centre. In addition, re‐evaluation of the UVB inflammation model using a reduced exposure paradigm (2MED) was performed in healthy subjects. Methods In the first study, all 142 subjects previously exposed to 3MED UVB were invited for a clinical evaluation of PIH. In the second study, 18 healthy subjects were exposed to 2MED UVB, and heat pain detection threshold (PDT) and PIH were evaluated. Results In total, 78 of the 142 subjects responded. The prevalence of PIH among responders was 53.8%. In the second study, we found a significant and stable difference in PDT between UVB‐exposed and control skin 3 hr after irradiation; 13 hr post‐irradiation, the least squares mean estimate of the difference in PDT ranged from −2.6°C to −4.5°C (p < 0.0001). Finally, the prevalence of PIH was lower in the 2MED group compared to the 3MED group. Conclusions The 3MED model is associated with a relatively high prevalence of long‐lasting PIH. In contrast, 2MED exposure produces stable hyperalgesia and has a lower risk of PIH and is therefore recommended for modelling inflammatory pain. Significance Postinflammatory hyperpigmentation is an unwanted long‐term side effect associated with the UVB inflammation model using the 3× minimal erythema dose (3MED) paradigm. In contrast, using a 2MED paradigm results in hyperalgesia that is stable for 36 hr and has a lower risk of inducing postinflammatory hyperpigmentation.
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Affiliation(s)
| | | | | | | | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Academic Centre for Drug Research, Leiden, The Netherlands
| | - Geert Jan Groeneveld
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Centre, Leiden, The Netherlands
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6
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van Amerongen G, Siebenga PS, Gurrell R, Dua P, Whitlock M, Gorman D, Okkerse P, Hay JL, Butt RP, Groeneveld GJ. Analgesic potential of PF-06372865, an α2/α3/α5 subtype-selective GABA A partial agonist, in humans. Br J Anaesth 2019; 123:e194-e203. [PMID: 30915991 DOI: 10.1016/j.bja.2018.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study investigated the analgesic effects of two doses (15 and 65 mg) of PF-06372865, a novel α2/α3/α5 gamma-aminobutyric acid A (GABAA) subunit selective partial positive allosteric modulator (PAM), compared with placebo and pregabalin (300 mg) as a positive control. METHODS We performed a randomised placebo-controlled crossover study (NCT02238717) in 20 healthy subjects, using a battery of pain tasks (electrical, pressure, heat, cold and inflammatory pain, including a paradigm of conditioned pain modulation). Pharmacodynamic measurements were performed at baseline and up to 10 h after dose. RESULTS A dose of 15 mg PF-06372865 increased pain tolerance thresholds (PTTs) for pressure pain at a ratio of 1.11 (90% confidence interval [CI]: 1.02, 1.22) compared with placebo. A dose of 65 mg PF-06372865 led to an increase in PTT for the cold pressor at a ratio of 1.17 (90% CI: 1.03, 1.32), and pressure pain task: 1.11 (90% CI: 1.01, 1.21). Pregabalin showed an increase in PTT for pressure pain at a ratio of 1.15 (95% CI: 1.06, 1.26) and cold pressor task: 1.31 (90% CI: 1.16, 1.48). CONCLUSION We conclude that PF-06372865 has analgesic potential at doses that do not induce significant sedation or other intolerable adverse events limiting its clinical use. In addition, the present study established the potential role for this battery of pain tasks as a tool in the development of analgesics with a novel mechanism of action, for the treatment of various pain states including neuropathic pain and to establish proof-of-concept. CLINICAL TRIALS REGISTRATION NCT0223871.
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Affiliation(s)
| | | | | | - Pinky Dua
- Early Clinical Development, Pfizer WRD, Cambridge, UK
| | - Mark Whitlock
- Early Clinical Development, Pfizer WRD, Cambridge, UK
| | - Donal Gorman
- Early Clinical Development, Pfizer WRD, Cambridge, UK
| | - Pieter Okkerse
- Centre for Human Drug Research (CHDR), Leiden, the Netherlands
| | - Justin L Hay
- Centre for Human Drug Research (CHDR), Leiden, the Netherlands
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7
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van Esdonk MJ, Lindeman I, Okkerse P, de Kam ML, Groeneveld GJ, Stevens J. Population Pharmacokinetic/Pharmacodynamic Analysis of Nociceptive Pain Models Following an Oral Pregabalin Dose Administration to Healthy Subjects. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2018; 7:573-580. [PMID: 30043517 PMCID: PMC6157667 DOI: 10.1002/psp4.12318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/23/2018] [Indexed: 12/18/2022]
Abstract
A battery of pain models can be used in clinical trials to investigate the efficacy and to establish the concentration‐effect relationship of novel analgesics. This study quantified the pharmacokinetics (PK) of pregabalin after a single oral dose of 300 mg and the pharmacodynamics (PD) on the pain tolerance threshold (PTT) of the cold pressor, electrical stimulation, the pressure pain model, and on the pain detection threshold of a contact heat pain model. The PK were best described using a one‐compartment model with lag time, linear absorption, and linear elimination. The PTT of the cold pressor showed a negative linear decrease over time without pregabalin. A linear drug effect was identified on the PTT of the cold pressor test and an on/off effect for the electrical stimulation PTT. No PK/PD relationship could be identified on the pressure pain and heat pain test. Citation:
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Affiliation(s)
- Michiel J van Esdonk
- Centre for Human Drug Research, Leiden, The Netherlands.,Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Ian Lindeman
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | | | | | - Jasper Stevens
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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8
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van Amerongen G, Siebenga P, de Kam ML, Hay JL, Groeneveld GJ. Effect profile of paracetamol, Δ9-THC and promethazine using an evoked pain test battery in healthy subjects. Eur J Pain 2018; 22:1331-1342. [PMID: 29635857 DOI: 10.1002/ejp.1222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND A battery of evoked pain tasks (PainCart) was developed to investigate the pharmacodynamic properties of novel analgesics in early-phase clinical research. As part of its clinical validation, compounds with different pharmacological mechanisms of actions are investigated. The aim was to investigate the analgesic effects of classic and nonclassic analgesics compared to a sedating negative control in a randomized placebo-controlled crossover study in 24 healthy volunteers using the PainCart. METHODS The PainCart consisted of pain tasks eliciting electrical, pressure, heat, cold and inflammatory pain. Subjective scales for cognitive functioning and psychotomimetic effects were included. Subjects were administered each of the following oral treatments: paracetamol (1000 mg), Δ9-THC (10 mg), promethazine (50 mg) or matching placebo. Pharmacodynamic measurements were performed at baseline and repeated up to 10 h postdose. RESULTS Paracetamol did not show a significant reduction in pain sensation or subjective cognitive functioning compared to placebo. Promethazine induced a statistically significant reduction in PTT for cold pressor and pressure stimulation. Furthermore, reduced subjective alertness was observed. Δ9-THC showed a statistically significant decrease in PTT for electrical and pressure stimulation. Δ9-THC also demonstrated subjective effects, including changes in alertness and calmness, as well as feeling high and psychotomimetic effects. CONCLUSIONS This study found a decreased pain tolerance due to Δ9-THC and promethazine, or lack thereof, using an evoked pain task battery. Pain thresholds following paracetamol administration remained unchanged, which may be due to insufficient statistical power. We showed that pain thresholds determined using this pain test battery are not driven by sedation. SIGNIFICANCE The multimodal battery of evoked pain tasks utilized in this study may play an important role in early-phase clinical drug development. This battery of pain tasks is not sensitive to the effects of sedation alone, and thus suitable to investigate the analgesic potential of novel analgesic compounds.
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Affiliation(s)
- G van Amerongen
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - P Siebenga
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - M L de Kam
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - J L Hay
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - G J Groeneveld
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
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9
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Loudon P, Siebenga P, Gorman D, Gore K, Dua P, van Amerongen G, Hay JL, Groeneveld GJ, Butt RP. Demonstration of an anti-hyperalgesic effect of a novel pan-Trk inhibitor PF-06273340 in a battery of human evoked pain models. Br J Clin Pharmacol 2017; 84:301-309. [PMID: 29178434 DOI: 10.1111/bcp.13448] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 08/30/2017] [Accepted: 09/23/2017] [Indexed: 02/06/2023] Open
Abstract
AIM Inhibitors of nerve growth factor (NGF) reduce pain in several chronic pain indications. NGF signals through tyrosine kinase receptors of the tropomyosin-related kinase (Trk) family and the unrelated p75 receptor. PF-06273340 is a small molecule inhibitor of Trks A, B and C that reduces pain in nonclinical models, and the present study aimed to investigate the pharmacodynamics of this first-in-class molecule in humans. METHODS A randomized, double-blind, single-dose, placebo- and active-controlled five-period crossover study was conducted in healthy human subjects (NCT02260947). Subjects received five treatments: PF-06273340 50 mg, PF-06273340 400 mg, pregabalin 300 mg, ibuprofen 600 mg and placebo. The five primary endpoints were the pain detection threshold for the thermal pain tests and the pain tolerance threshold for the cold pressor, electrical stair and pressure pain tests. The trial had predefined decision rules based on 95% confidence that the PF-06273340 effect was better than that of placebo. RESULTS Twenty subjects entered the study, with 18 completing all five periods. The high dose of PF-06273340 met the decision rules on the ultraviolet (UV) B skin thermal pain endpoint [least squares (LS) mean vs. placebo: 1.13, 95% confidence interval: 0.64-1.61], but not on the other four primary endpoints. The low dose did not meet the decision criteria for any of the five primary endpoints. Pregabalin (cold pressor and electrical stair tests) and ibuprofen (UVB thermal pain) showed significant analgesic effects on expected endpoints. CONCLUSIONS The study demonstrated, for the first time, the translation of nonclinical effects into man in an inflammatory pain analgesic pharmacodynamic endpoint using a pan-Trk inhibitor.
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Affiliation(s)
- Peter Loudon
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
| | - Pieter Siebenga
- Centre for Human Drug Research, Zernikedreef, 8,2333 CL, Leiden, the Netherlands
| | - Donal Gorman
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
| | - Katrina Gore
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
| | - Pinky Dua
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
| | - Guido van Amerongen
- Centre for Human Drug Research, Zernikedreef, 8,2333 CL, Leiden, the Netherlands
| | - Justin L Hay
- Centre for Human Drug Research, Zernikedreef, 8,2333 CL, Leiden, the Netherlands
| | - Geert Jan Groeneveld
- Centre for Human Drug Research, Zernikedreef, 8,2333 CL, Leiden, the Netherlands
| | - Richard P Butt
- Neuroscience and Pain Research Unit, Pfizer WRD, Cambridge, UK
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10
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Okkerse P, van Amerongen G, de Kam ML, Stevens J, Butt RP, Gurrell R, Dahan A, van Gerven JM, Hay JL, Groeneveld GJ. The use of a battery of pain models to detect analgesic properties of compounds: a two-part four-way crossover study. Br J Clin Pharmacol 2017; 83:976-990. [PMID: 27862179 DOI: 10.1111/bcp.13183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/30/2016] [Accepted: 11/01/2016] [Indexed: 12/29/2022] Open
Abstract
AIM The aim was to investigate the ability of a battery of pain models to detect analgesic properties of commonly used analgesics in healthy subjects. METHODS The battery consisted of tests eliciting electrical, mechanical and thermal (contact heat and cold pressor)-pain and included a UVB model, the thermal grill illusion and a paradigm of conditioned pain modulation. Subjects were administered fentanyl 3 μg kg-1 , phenytoin 300 mg, (S)-ketamine 10 mg and placebo (part I), or imipramine 100 mg, pregabalin 300 mg, ibuprofen 600 mg and placebo (part II). Pain measurements were performed at baseline and up to 10 h post-dose. Endpoints were analysed using a mixed model analysis of variance. RESULTS Sixteen subjects (8 female) completed each part. The pain tolerance threshold (PTT) for electrical stimulation was increased (all P < 0.05) compared to placebo for (S)-ketamine (+10.1%), phenytoin (+8.5%) and pregabalin (+10.8%). The PTT for mechanical pain was increased by pregabalin (+14.1%). The cold pressor PTT was increased by fentanyl (+17.1%) and pregabalin (+46.4%). Normal skin heat pain detection threshold was increased by (S)-ketamine (+3.3%), fentanyl (+2.8%) and pregabalin (+4.1%). UVB treated skin pain detection threshold was increased by fentanyl (+2.6%) and ibuprofen (+4.0%). No differences in conditioned pain modulation were observed. CONCLUSION This study shows that these pain models are able to detect changes in pain thresholds after administration of different classes of analgesics in healthy subjects. The analgesic compounds all showed a unique profile in their effects on the pain tasks administered.
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Affiliation(s)
- Pieter Okkerse
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | | | | | - Jasper Stevens
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - Richard P Butt
- Neuroscience and Pain Research Unit, Pfizer Worldwide Research and Development, Cambridge, UK
| | - Rachel Gurrell
- Neuroscience and Pain Research Unit, Pfizer Worldwide Research and Development, Cambridge, UK
| | - Albert Dahan
- Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | | | - Justin L Hay
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
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