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Papers of the Week

Papers: 15 Feb 2020 - 21 Feb 2020

Pharmacology/Drug Development

2020 Feb 19

Expert Opin Investig Drugs

Neuropathic pain: preclinical and early clinical progress with voltage-gated sodium channel blockers.


Kushnarev M, Pirvulescu I P, Candido KD, Knezevic N N
Expert Opin Investig Drugs. 2020 Feb 19:1-13.
PMID: 32070160.


: Neuropathic pain is a chronic condition that significantly affects the quality of life of millions of people globally. Most of the pharmacologic treatments currently in use demonstrate modest efficacy and over half of all patients do not respond to medical management. Hence, there is a need for new, efficacious drugs. Evidence points toward voltage-gated sodium channels as a key target for novel analgesics.: The role of voltage-gated sodium channels in pain pathophysiology is illuminated and the preclinical and clinical data for new sodium channel blockers and toxin-derived lead compounds are examined. The expansion of approved sodium channel blockers is discussed along with the limitations of current research, trends in drug development, and the potential of personalized medicine.: The transition from preclinical to clinical studies can be difficult because of the inherent inability of animal models to express the complexities of pain states. Pain pathways are notoriously intricate and may be pharmacologically modulated at a variety of targets; it is unlikely that action at a single target could completely abolish a pain response because pain is rarely unifactorial. Combination therapy may be necessary and this could further confound the discovery of novel agents.