Shaping a new interventional drug treatment for peripheral neuropathic pain

Authors

• A Gittis
• RD Leapman
• PE Duffy
• A Jin
• DL Narum

Abstract

Peripheral neuropathic pain (PNP) affects 10 to 30 million people in the general population and results from a broad array of causes including direct nerve injury, viral infection, metabolic problems such as diabetes, and chemical insults. The shear variety of etiologies and sites of nerve damage make effective treatment difficult, and currently available agents do not provide complete pain relief. We have developed a new interventional approach to peripheral neuropathic pain treatment that can be adapted to the varied sites of pain generation. The treatment involves instillation of the potent and highly selective TRPV1 agonist resiniferatoxin (RTX), to inactivate pain fibers in affected peripheral nerve. Morton’s neuroma (MN) is a chronic pain condition characterized by burning, stabbing, or shooting pain upon weight-bearing in the ball of the foot due to nerve damage. Its localized nature makes MN an optimal model for testing neuropathic pain symptomatology and the proposed treatment. We report on our initial pain phenotyping of MN patients and controls using comprehensive quantitative sensory testing (QST) to subjectively assess responses to innocuous and noxious thermal, mechanical, and deep tissue pressure stimuli. Patients with MN had lower pressure pain thresholds and reported higher pressure pain ratings in comparison to healthy participants and an extended area of heat hyperalgesia in the MN affected foot. We are about to commence a Phase I clinical trial to treat refractory MN pain using perineural injection of RTX. We hypothesize this compound, and this route will provide effective pain relief in MN patients.

Scientific Focus Area: Clinical Research

This page was last updated on Monday, September 25, 2023