The effects of the TRPV1 antagonist SB-705498 on TRPV1 receptor-mediated activity and inflammatory hyperalgesia in humans

Pain. 2007 Nov;132(1-2):132-41. doi: 10.1016/j.pain.2007.06.006. Epub 2007 Jul 30.

Abstract

TRPV1 is a cation channel activated by a range of noxious stimuli and highly expressed in nociceptive fibres. TRPV1 receptors are involved in pain and sensitisation associated with tissue injury and inflammation; hence, TRPV1 antagonists are potentially useful for the treatment of such pain states. SB-705498 is a potent, selective and orally bioavailable TRPV1 antagonist with demonstrated efficacy in a number of preclinical pain models. In this first-time-into-human study, we have investigated the pharmacodynamic and antihyperalgesic activity of SB-705498. The compound was safe and well tolerated at single oral doses up to 400mg. In a cohort of 19 healthy volunteers, we used a randomised placebo-controlled single-blind cross-over design to assess the effects of SB-705498 (400mg) on heat-evoked pain and skin sensitisation induced by capsaicin or UVB irradiation. Compared with placebo, SB-705498 reduced the area of capsaicin-evoked flare (P=0.0047). The heat pain threshold on non-sensitised skin was elevated following SB-705498 (estimated difference from placebo [95% confidence intervals]: 1.3 degrees C [0.07,2.53], P=0.019). Following capsaicin sensitisation, the heat pain threshold and tolerance were similar between SB-705498 and placebo. However, SB-705498 increased heat pain tolerance at the site of UVB-evoked inflammation (estimated difference from placebo: 0.93 degrees C [0.25,1.6], P=0.0054). The magnitude of the pharmacodynamic effects of SB-705498 appeared to be related to plasma concentration. These results indicate that SB-705498, at a clinically safe and well-tolerated dose, has target-specific pharmacodynamic activity in humans. These data provide the first clinical evidence that a TRPV1 antagonist may alleviate pain and hyperalgesia associated with inflammation and tissue injury.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Analgesics / administration & dosage
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Female
  • Hot Temperature
  • Humans
  • Hyperalgesia / drug therapy*
  • Hyperalgesia / physiopathology*
  • Inflammation / drug therapy
  • Inflammation / physiopathology
  • Male
  • Middle Aged
  • Pain Measurement / drug effects*
  • Placebo Effect
  • Pyrrolidines / administration & dosage*
  • Signal Transduction / drug effects*
  • TRPV Cation Channels / antagonists & inhibitors*
  • TRPV Cation Channels / metabolism*
  • Treatment Outcome
  • Urea / administration & dosage
  • Urea / analogs & derivatives*

Substances

  • Analgesics
  • Pyrrolidines
  • SB 705498
  • TRPV Cation Channels
  • TRPV1 protein, human
  • TRPV1 receptor
  • Urea