The State of Synthetic Cannabinoid Medications for the Treatment of Pain.

IF 7.4 2区 医学 Q1 CLINICAL NEUROLOGY
CNS drugs Pub Date : 2024-08-01 Epub Date: 2024-07-01 DOI:10.1007/s40263-024-01098-9
Anca Maglaviceanu, Miki Peer, Jason Rockel, Robert P Bonin, Mary-Ann Fitzcharles, Karim S Ladha, Anuj Bhatia, Timothy Leroux, Lakshmi Kotra, Mohit Kapoor, Hance Clarke
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Abstract

Synthetic cannabinoids are compounds made in the laboratory to structurally and functionally mimic phytocannabinoids from the Cannabis sativa L. plant, including delta-9-tetrahydrocannabinol (THC). Synthetic cannabinoids (SCs) can signal via the classical endogenous cannabinoid system (ECS) and the greater endocannabidiome network, highlighting their signalling complexity and far-reaching effects. Dronabinol and nabilone, which mimic THC signalling, have been approved by the Food and Drug Administration (FDA) for treating nausea associated with cancer chemotherapy and/or acquired immunodeficiency syndrome (AIDS). However, there is ongoing interest in these two drugs as potential analgesics for a variety of other clinical conditions, including neuropathic pain, spasticity-related pain, and nociplastic pain syndromes including fibromyalgia, osteoarthritis, and postoperative pain, among others. In this review, we highlight the signalling mechanisms of FDA-approved synthetic cannabinoids, discuss key clinical trials that investigate their analgesic potential, and illustrate challenges faced when bringing synthetic cannabinoids to the clinic.

Abstract Image

合成大麻素药物治疗疼痛的现状。
合成大麻素是在实验室中制成的化合物,在结构上和功能上模仿来自大麻(Cannabis sativa L.)植物的植物大麻素,包括δ-9-四氢大麻酚(THC)。合成大麻素(SCs)可通过经典的内源性大麻素系统(ECS)和更大的内源性大麻素网络发出信号,突出了其信号的复杂性和深远影响。屈大麻酚和纳比隆模拟四氢大麻酚信号,已被美国食品药品管理局(FDA)批准用于治疗癌症化疗和/或获得性免疫缺陷综合征(艾滋病)引起的恶心。然而,人们对这两种药物作为潜在镇痛剂治疗其他各种临床病症的兴趣也在不断增长,包括神经性疼痛、痉挛相关疼痛、非痉挛性疼痛综合征(包括纤维肌痛、骨关节炎和术后疼痛等)。在这篇综述中,我们将重点介绍经 FDA 批准的合成大麻素的信号机制,讨论研究其镇痛潜力的主要临床试验,并说明将合成大麻素应用于临床时所面临的挑战。
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来源期刊
CNS drugs
CNS drugs 医学-精神病学
CiteScore
12.00
自引率
3.30%
发文量
82
审稿时长
6-12 weeks
期刊介绍: CNS Drugs promotes rational pharmacotherapy within the disciplines of clinical psychiatry and neurology. The Journal includes: - Overviews of contentious or emerging issues. - Comprehensive narrative reviews that provide an authoritative source of information on pharmacological approaches to managing neurological and psychiatric illnesses. - Systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. - Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in neurology and psychiatry. - Original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in CNS Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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