Intense pain that radiates to the face or teeth can cause severe distress for sufferers. This condition, known as trigeminal neuralgia, is recognized as one of the most severe forms of chronic nerve pain. Patients experience episodes of pain triggered by simple actions such as shaving, applying makeup, bathing, speaking, brushing teeth, or even a breeze. The root cause is often linked to irritation of the trigeminal nerve, which is crucial for transmitting sensory information from the face, certain areas of the scalp, and the mouth.
Nevertheless, a new hope has emerged for those affected by this condition. A substance that has recently undergone testing shows promise in reducing the pain to bearable levels. This is based on the optimistic outcomes of a phase II international study, which saw participation from the Center of Dental Medicine at the University of Zurich.
One of the significant advancements is the reduction of adverse side effects. Pain signals are transmitted to the brain by activating sodium channels within the nerve cell membranes. The sodium channel known as “1.7” is particularly active in nerves that carry pain signals, with increased activity correlating to more intense pain. Traditionally, blocking this channel, for instance, through a local anaesthetic, can prevent the transmission of pain signals. In cases of trigeminal neuralgia, it is believed that nerve damage occurs near the base of the skull, a region difficult to target with injections, making oral medication necessary.
The substance BIIB074 in the study targets the sodium channel 1.7 state-dependently. That means it blocks the channel more effectively the more active the channel is. This approach contrasts with treatments that block the channel regardless of activity, often leading to significant side effects. According to Dominik Ettlin, a dental specialist at UZH, “BIIB074 has shown not only to be effective but also to have a significantly better tolerance in patients, without the common side effects like fatigue and concentration issues associated with conventional drugs.” He added that further testing on a larger scale in the following study phase would be crucial to confirm if this new treatment offers a more effective solution for managing pain.
More information: Joanna M Zakrzewska et al, Safety and efficacy of a Nav1.7 selective sodium channel blocker in patients with trigeminal neuralgia: a double-blind, placebo-controlled, randomised withdrawal phase 2a trial, The Lancet Neurology. DOI: 10.1016/S147-4422
Journal information: The Lancet Neurology Provided by University of Zurich
