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Neuropathic pain: From actual pharmacological treatments to new therapeutic horizons
Pharmacology & Therapeutics ( IF 13.5 ) Pub Date : 2023-10-11 , DOI: 10.1016/j.pharmthera.2023.108546
Maxime Thouaye 1 , Ipek Yalcin 2
Affiliation  

Neuropathic pain, caused by a lesion or disease affecting the somatosensory system, affects between 3 and 17% of the general population. The treatment of neuropathic pain is challenging due to its heterogeneous etiologies, lack of objective diagnostic tools and resistance to classical analgesic drugs. First-line treatments recommended by the Special Interest Group on Neuropathic Pain (NeuPSIG) and European Federation of Neurological Societies (EFNS) include gabapentinoids, tricyclic antidepressants (TCAs) and selective serotonin noradrenaline reuptake inhibitors (SNRIs). Nevertheless these treatments have modest efficacy or dose limiting side effects. There is therefore a growing number of preclinical and clinical studies aim at developing new treatment strategies to treat neuropathic pain with better efficacy, selectivity, and less side effects. In this review, after a brief description of the mechanisms of action, efficacy, and limitations of current therapeutic drugs, we reviewed new preclinical and clinical targets currently under investigation, as well as promising non-pharmacological alternatives and their potential co-use with pharmacological treatments.



中文翻译:

神经性疼痛:从实际的药物治疗到新的治疗视野

神经性疼痛是由影响体感系统的病变或疾病引起的,影响着 3% 至 17% 的普通人群。由于其病因复杂、缺乏客观的诊断工具以及对经典镇痛药物的耐药性,神经性疼痛的治疗具有挑战性。神经性疼痛特别兴趣小组 (NeuPSIG) 和欧洲神经学会联合会 (EFNS) 推荐的一线治疗包括加巴喷丁类药物、三环类抗抑郁药 (TCA) 和选择性血清素去甲肾上腺素再摄取抑制剂 (SNRI)。然而,这些治疗具有适度的功效或剂量限制性副作用。因此,越来越多的临床前和临床研究旨在开发新的治疗策略,以更好的疗效、选择性和更少的副作用来治疗神经性疼痛。在这篇综述中,在简要描述了当前治疗药物的作用机制、功效和局限性之后,我们回顾了目前正在研究的新的临床前和临床靶标,以及有前途的非药物替代品及其与药物联合使用的潜力治疗。

更新日期:2023-10-14
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