Tapentadol ER® en Olesoxime bij neuropathie?
De titel van de presentatie tijdens de 26e vergadering van de ‘American Academy of Pain Medicine’ (AAPM) was:
- Efficacy and Tolerability of Tapentadol Extended Release® for Diabetic Peripheral Neuropathic Pain: Results of a Randomized-Withdrawal, Double-Blind, Placebo-Controlled Phase 3 Study.
Het was Abstract 113.
- This randomised-withdrawal, double-blind, phase 3 study involved patients aged 18 years or older with type 1 or type 2 diabetes with a diagnosis of painful diabetic peripheral neuropathy. And symptoms for a minimum of 6 months. Patients had analgesic treatment for painful diabetic peripheral neuropathy for at least 3 months and were not satisfied with their current treatment.
During the 3-week open-label period, 588 patients were titrated to an optimal dose of tapentadol ER 100 to 250 mg twice daily. The majority of these patients (79.4%) had a pain intensity rating >=6 on the 11-point NRS.The double-blind phase consisted of a 12-week maintenance period, during which patients received >=1 dose of study medication.
A total of 395 patients had a >=1 point improvement in pain intensity and were then randomised in a 1:1 ratio to tapentadol ER or placebo.The primary efficacy endpoint was the improvement in pain intensity during the double-blind treatment phase. During the double-blind period, the tapentadol ER group had an average pain intensity that remained relatively constant, while the placebo group had a pain intensity that increased in severity (P < .001). Of those patients involved in the double-blind phase of the study, 11.2% of patients in the tapentadol ER group and 5.7% of patients in the placebo group discontinued due to adverse events. The most common adverse events were gastrointestinal related and led to discontinuation in 10% of patients.
TRO19622: Olesoxime bij pijnlijke neuropathie
Een ander middel: TRO19622, de codenaam voor de stof olesoxime, wordt momenteel onderzocht bij pijnlijke neuropathie. Het is een cholesterol-achtige stof die ontwikkeld is om iets te doen aan ALS. Uit dierproeven bleek de neuroprotectieve werkzaamheid, op basis van de werking in de energiecentrales van de cel.
Daarom wordt het nu in de VS getest bij pijnlijke polyneuropathie door een chemokuur:
- Olesoxime targets mitochondrial proteins and its effects are consistent with the mitotoxicity hypothesis for paclitaxel-evoked painful peripheral neuropathy. We conclude that olesoxime may be useful clinically for both the prevention and treatment of paclitaxel-evoked painful peripheral neuropathy. 
Maart 2010, Prof. dr. Jan M. Keppel Hesselink
‘Tapentadol en Olesoxime bij neuropathie?’
Bekijk hier de video’s van onze artsen.
 Xiao WH, Zheng FY, Bennett GJ, Bordet T, Pruss RM. | Olesoxime (cholest-4-en-3-one, oxime): analgesic and neuroprotective effects in a rat model of painful peripheral neuropathy produced by the chemotherapeutic agent, paclitaxel. | Pain. | 2009 Dec 15;147(1-3):202-9. Epub 2009 Oct 14.