Mirogabalin: a novel gabapentinoid or another false dawn?

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-09-01 Epub Date: 2024-07-31 DOI:10.1097/SPC.0000000000000714

Thomas J Craig, Paul Farquhar-Smith

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引用次数: 0

Abstract

Purpose of review: Mirogabalin is a novel gabapentinoid medication for the treatment of neuropathic pain. The purpose of this review is to discuss current evidence for its use. Gabapentinoids are widely prescribed for neuropathic pain. Mirogabalin offers theoretical advantages over traditional gabapentinoids due to its specificity for the α2δ-1 subunit of voltage-gated calcium channels. It is theorised that this specificity may reduce adverse drug reactions by minimising binding to the α2δ-2 subunit which is responsible for many of the gabapentinoid side effects.

Recent findings: Mirogabalin's slower dissociation from the α2δ-1 compared with α2δ-2, and its higher potency may also impart an efficacy benefit over traditional gabapentinoids. These theoretical advantages of mirogabalin remain inconclusive in clinical practice, with mixed evidence regarding mirogabalin versus traditional gabapentinoids. Some studies suggest a reduced side effect profile yet, others fail to demonstrate significant differences. Regarding efficacy, mirogabalin may be superior to placebo for several neuropathic pain syndromes, but evidence of widespread benefit over traditional gabapentinoids is currently lacking.

Summary: Mirogabalin offers theoretical promise, but large, independent studies are required to further assess its performance versus traditional gabapentinoids.

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米罗加巴林：新型加巴喷丁类药物还是另一个假曙光？

综述目的：米罗加滨是一种治疗神经性疼痛的新型加巴喷丁类药物。本综述旨在讨论其使用的现有证据。加巴喷丁类药物被广泛用于治疗神经性疼痛。与传统的加巴喷丁类药物相比，米罗加滨具有理论上的优势，因为它对电压门控钙通道的α2δ-1亚基具有特异性。据推测，这种特异性可最大限度地减少与α2δ-2亚基的结合，从而减少药物不良反应，而α2δ-2亚基是造成许多加巴喷丁类药物副作用的原因：最新发现：与α2δ-2亚基相比，米罗加巴林与α2δ-1亚基的解离速度较慢，而且药效更强，这也可能使其在疗效上优于传统的加巴喷丁类药物。米瑞巴林的这些理论优势在临床实践中仍无定论，有关米瑞巴林与传统加巴喷丁类药物的证据不一。一些研究表明米瑞巴林的副作用有所减轻，但另一些研究则未能证明两者之间存在显著差异。在疗效方面，米罗卡巴林对几种神经病理性疼痛综合征的疗效可能优于安慰剂，但目前尚缺乏证据表明米罗卡巴林比传统的加巴喷丁类药物具有更广泛的疗效。小结：米罗卡巴林具有理论上的前景，但还需要进行大规模的独立研究，以进一步评估其与传统加巴喷丁类药物相比的性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.