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GOOD NEWS! New drug may turn off chronic pain without addiction or tolerance problems; trials at Columbia

  [ 245 votes ]   [ 10 Comments ]
www.ProHealth.com • July 19, 2010


New drug may turn off chronic pain without addiction or tolerance problemsFour years ago researchers at Columbia University Medical Center, New York, discovered an "On/Off switch" for chronic pain signals.(1) They raised pain patients’ hopes around the world when they applied for patents to develop a new type of drug that could flip that switch. And now they believe they have one – a drug that has proved powerful in animal trials, while avoiding tolerance, addiction, and sedative problems.

The researchers, who have been working to combat injury-related depression, substance abuse, and suicide due to unremitting, persistent pain, have dubbed the new analgesic “N60” and now plan human trials. (Meaning, unfortunately, that approval and general availability of the drug, if it fulfills its early promise, is still some time off.)

First, they Discovered the Chronic Pain Pathway

Pain is a perception in the brain triggered by signals sent along nerves in the peripheral nervous system. It is a sensation that serves as a defense mechanism for the organism, but how it works is only beginning to be understood. Scientists now know, though, that there are several pathways by which the brain perceives different types of pain.

The chronic pain team, led by Dr. Richard Ambron, Professor of Pathology & Cell Biology, began to develop N60 after his colleague, Dr. Ying-Ju Sung, Assistant Professor of Clinical Pathology, discovered the pathway that neurons use to inform the brain of an injury.

Left uncontrolled, this pathway persistently alters the electrical properties of the neuron, ultimately causing chronic pain.

Then the “On-Off Switch”…

The Columbia team found that a specific protein in the pathway, called “PKG,” acts like a switch. As long as the switch is on, the pathway is activated and the brain continues to receive signals that are perceived as pain, even after an injury has healed.

Sung and Ambron quickly realized that PKG would be an excellent target for drug development.

• Since PKG is specific for the biochemical signaling involved with chronic pain, shutting off PKG will not prevent a patient from feeling fresh injuries.

• It also operates in the peripheral nervous system, rather than the central nervous system (brain & spinal cord). This means that a drug that blocks PKG does not have to cross the blood-brain barrier, a formidable challenge in drug development.

“The only drugs that work consistently on chronic pain are opiates and anti-depressants,” said Ambron. “A significant problem with opiates is that extended use often leads to addiction.”

“Everyone is looking for a solution that is not addictive,” Sung added. “There’s increasing concern, from clinicians, patients, and regulatory agencies, with drugs that act on the central nervous system - where addiction can develop.”

And Now the Drug

Once they understood the function of PKG:

• The team began to work with medicinal chemists in Dr. Donald Landry’s group, also at Columbia, to design a compound that would block PKG from sending signals to the brain.

• After considerable effort, they discovered N60, which laboratory tests have shown to be a powerful and very selective PKG blocker.

“We found in PKG a well-defined target that has been implicated in several types of pain that are particularly refractory to treatment,” Ambron said. “Now, we have an excellent inhibitor of the target:

• “Which imparts no evident toxic or behavioral side effects and which also alleviates chronic pain in animal models of nerve injury and inflammation.

• “N60 is non-addictive and non-sedative, and a single dose attenuates pain for at least 24 hours.”

Especially Promising for Military Personnel

Ambron and Sung believe N60 may have particularly meaningful impact for military personnel, who are at particularly high risk of suffering from chronic pain due to combat-related physical injuries and emotional stress.

• Recent pilot studies show analgesic effects in an animal model of neuroma, an abnormal growth in nerves. Neuromas can be extremely painful and result from injury to nerves, such as that caused by limb loss from trauma, amputations, or from other surgeries.

• Additionally, a growing body of research is finding direct biochemical connections between chronic pain and Post-Traumatic Stress Disorder (PTSD), anxiety, depression, and suicide.

Pharmaceutical Grade Compound Ready for Human Safety Studies

Funding to date has allowed the Columbia team to manufacture pharmaceutical (GMP)-grade compound, ready for studies which will evaluate the safety of the drug.

“We’ve got the drug, we’re confident in its efficacy, and we are actively looking for investors and experienced partners to help us put this through clinical testing,” explains Jerry Kokoshka, a representative from Columbia Technology Ventures, the university office that oversees commercialization of novel technologies. “Anyone who has ever experienced the suffering of chronic pain, personally or through a family member or friend, knows the intense frustration and emotional burden of this problem.

“We believe a compound like N60 has significant potential to transform the way chronic pain is treated,” Ambron said.

“If it works the way we think it can, we may be able to alleviate chronic pain in some of its most intractable forms without the risk of addiction, a problem that conveys a whole set of economic and social issues for our country and society at-large.”
____
1.  “Columbia University Researchers Discover On/Off Switch for Chronic Pain”

Source: Columbia Technology Ventures news release, July 15, 2010, modified




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New Drug N60 for pain
Posted by: dianamary521
Jul 28, 2010
New drug (N60) for pain sounds very promising. I have been suffering with Fibromyalgia for over ten years and would welcome relief from the chronic pain. I had been put on opiates, but decided to get off them 2 years ago. They work for awhile, but in the end became like a tiger chasing its tail. I hope this new drug is not like so many that are out there that have so many side effects. I look forward to hearing more about it in the near future. It would be so wonderful to actually have a day with NO pain. Hopeful!
Reply Reply

Pill to turn off pain vs narcotics
Posted by: LADYBUG64
Jul 28, 2010
I believe it is wonderful that they may find such a drug to help those of us with chronic pain. However, I do not agree that addiction is a common problem with people who take narcotics for chronic pain. Maybe it is not the best solution if this new drug works. But I am very pro-narcotic for chronic pain. Studies have shown that less than 2% of people who take narcotics for chronic pain ever become "addicted". There is a big difference in "addiction" and "dependence". Yes, I am narcotic dependent to fight pain but I am not an addict. I do not have addictive behavior. I do not "crave" a narcotic nor do I take more than prescribed or more than is needed for the pain itself. I do not take a narcotic for a "high". I am fed up with all the media bashing of narcotic pain meds just because so many people choose to abuse them especially in the circle of celebrities. We never hear of people who take naroctics safely and efficiently for years to control pain adequately. We only hear the negative side of the drugs. This is specifically why it is true that now many physicians would rather let someone suffer chronic pain rather than prescribe a narcotic drug which would help them. If the new med being tested arrives on the market and works, I am all for it. But I am just offended by the bad reputation of people who take narcotic pain meds for real pain and take them legally and as prescribed in order to have some quality of life. Debra R.N. and fibromyalgia patient
Reply Reply

 
Agreeing with Debrah
Posted by: caitlink69
Jul 29, 2010
It would be a wonderful thing if we could actually have a medication that came without all the stigma's attached to opiates. I for one, have been treated like a drug seeking junkie, even when I refused the medications. I get harassed at the pharmacy if I ask a question about my medication, they immediately call my Pain Management Doctor like I'm trying to do something wrong and twist what I have said. I get harassed or treated badly by Doctors who don't agree with my usage or treatment plan. I get harassed by friends and family who don't understand that everyone taking opiates in not a drug addict. We take these medications to FUNCTION BETTER, not sit on the couch and drool all day.I work full time, take classes, take care of my family and try to be as involved as I can in the wake of endless debilitating pain. The only thing that lets me keep going is the pain medication and Lord knows I don't WANT to take these meds. No one in their right mind would, with all the bad treatment and judgments involved. And like Debrah said we are NOT getting high off these medications when you have chronic pain and are taking them as prescribed. It makes me so angry that just because there is POTENTIAL for abuse that every single person taking them gets treated as if they are already in the addicted category. When is this madness going to stop? Now the FDA wants to regulate how many milligrams your Pain Management Doctor can prescribe, as well as make it harder for Doctors to become qualified to dispense them. Frankly, I'm fed up and angry...and ready to fight back for my LIFE!

 

 
Pill to turn off pain vs Narcotics
Posted by: SimonM
Jul 29, 2010
Thank you Debra for your intelligent and beautifully written comment. I totally agree with all the points you bring out. I had to discontinue my training to become an RN due to horrible, debilitating pain of Fibromyalgia. It took years of searching and suffering to find a doctor that would help me. I've been using narcotic pain relief now for nearly ten years. As the other commentor very accurately said, I take the meds in order to FUNCTION BETTER. With the use of narcotics for pain relief I am able to actually have a life worth living. I am narcotic dependant but am not an addict. I have never once misused my meds and I have no desire whatsoever to do so. I too, am sick to death of only hearing the bad side of opiate use and dealing with the stigma. Somehow we need to inform the public about the many, many patients who must use these medications and who do so responsibly.

 

 
narcotic-med users misunderstood
Posted by: wiselittlebear
Aug 11, 2010
I am also a nurse, and I AGREE! Patients with pain taking the proper type and dose of medication will not experience a high. I worry about the long-term effects of my pain med. I have been on this med for over ten years without having to increase the dose more than infrequently.

That said, it would be wonderful to have a drug for chronic pain that didn't have the drawbacks of opiates. How do I (or my husband, who has RA, spinal stenosis, and fibromyalgia) get considered for this drug trial?

 


New pain pill
Posted by: eaglehaslanded
Jul 29, 2010
I agree with the gal who is sick & tired of being classified as a "hop-head". I,too, survive Fibromyalgia each & every day of my life. And, atop that, broke my leg in 3 places this past Jan. Now, there's a WHOLE LOTTA PAIN!! We need these medications because we would have no quality of life without them. We aren't taking "dope" to get a high. We're taking our medication(s) in order to be able to function in life. Have a great day! The eaglehaslanded :)
Reply Reply

 
Hey there eaglehaslanded!
Posted by: G M Kline-de Hart
Aug 2, 2010
I have had FM for 22 years now and for the first 11(!!) received NO narcotics because I was "drug seeking" and, I was even an RN! I harmed my liver by trying to live and relax by using alcohol and I took so much aspirin, acetaminophen and ibuprofen in order to work so I could support myself that my liver enzymes are now elevated! Finally, my fiance' took me to his D.O. and he diagnosed me immediately with FM. I felt immediate validation for something I had lived with and been denied help for for 11 yrs.! That's really malpractice! It's sad that the incredible advances in medicine have not caught up in the pain realm!! Now, though, I am on methadone for pain control due to allergies to other opiates and so now, I deal with people thinking I was an addict that is now using methadone instead! Wake up world!! There are those of us who are in serious trouble and would go insane if we did not have pain control. I don't drink any alcohol anymore and take valium for severe spasms and trigger point flare ups. You are not alone out there!

 


Hurray! Turn my pain off!
Posted by: G M Kline-de Hart
Aug 2, 2010
What a blessing that would be, right? To move freely outside of water and not feel pain--a dream come true and I believe we will see the day if not in my lifetime, it will happen. Patience and optimism aren't always present in my life, but when they are and I can muster the strength to fight the pain, it's so worth while!! Keep researching for us, please!
Reply Reply

New Meds
Posted by: igarfy
Aug 17, 2010
I too am interested in any new med for the relief of pain. I agree totally with the ones before me stating that there is a difference in drug dependence and addiction. I suffer very bad pain every day from Fibromyalgia and Osteomalagia ( micro fractures in my hips and pubic area) I can't sit for more than 3 minutes and I am in horrible pain. I take pills now to live. I don't take more than my prescription states. However, I have tried most of the other newer drugs and have had severe reactions with all of them. It has gotten so bad with the new meds that my doctor now says don't take any medication unless it has been out 10 years. The horrible side effects I have suffered with these new meds along with my daily horrible pain has left me very leary of any new medication.
Reply Reply

N60 for chronic pain
Posted by: Butter1232
Sep 29, 2011
I recently read an article in Discover Magazine and became very interested in this new treatment. My husband had a near fatal motorcycle accident 2 years ago and broke both of his lower legs which were repaired with rods and screws. He is in constant debilitating pain and takes strong opoids for relief. He is now addicted and it has really taken a toll on our marriage, it has become a nightmare to say the least. Along with the severe withdrawal sickness that happpens nearly every month because he uses up his medicine too quickly and runs out, he takes our money, lots of it and buys drugs on the street to get him through to his next prescription. He knows what he does is wrong and he says he does not know what drives him to lie and steal. Its like a possesion of a mind and body by a demon drug. He cannot go without it because the pain is so bad that he needs it just to walk. It is really a pitiful heartbreaking dilemma and he cries in pain, and for betraying his family. I feel so bad for him, yet angry at the same time because he does this and knows better. Thats our problem, and N60 sounds so wonderful - the article stated that when used on rats that had manufactured chronic pain, their pain disappeared in 45 minutes! I pray for the day that this is available to humans. My husband says almost everyday "I cannot live like this." He would be willing to participate in medical trials. We are desperate. I am searching for more information, if anyone can help, please post. Lynne
Reply Reply


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