Ketoprofen, lysine and gabapentin co-crystal magnifies synergistic efficacy and tolerability of the constituent drugs: Pre-clinical evidences towards an innovative therapeutic approach for neuroinflammatory pain - 23/05/23
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Abstract |
Chronic pain is an enormous public health concern, and its treatment is still an unmet medical need. Starting from data highlighting the promising effects of some nonsteroidal anti-inflammatory drugs in combination with gabapentin in pain treatment, we sought to combine ketoprofen lysine salt (KLS) and gabapentin to obtain an effective multimodal therapeutic approach for chronic pain. Using relevant in vitro models, we first demonstrated that KLS and gabapentin have supra-additive effects in modulating key pathways in neuropathic pain and gastric mucosal damage. To leverage these supra-additive effects, we then chemically combined the two drugs via co-crystallization to yield a new compound, a ternary drug-drug co-crystal of ketoprofen, lysine and gabapentin (KLS-GABA co-crystal). Physicochemical, biodistribution and pharmacokinetic studies showed that within the co-crystal, ketoprofen reaches an increased gastrointestinal solubility and permeability, as well as a higher systemic exposure in vivo compared to KLS alone or in combination with gabapentin, while both the constituent drugs have increased central nervous system permeation. These unique characteristics led to striking, synergistic anti-nociceptive and anti-inflammatory effects of KLS-GABA co-crystal, as well as significantly reduced spinal neuroinflammation, in translational inflammatory and neuropathic pain rat models, suggesting that the synergistic therapeutic effects of the constituent drugs are further boosted by the co-crystallization. Notably, while strengthening the therapeutic effects of ketoprofen, KLS-GABA co-crystal showed remarkable gastrointestinal tolerability in both inflammatory and chronic neuropathic pain rat models. In conclusion, these results allow us to propose KLS-GABA co-crystal as a new drug candidate with high potential clinical benefit–to–risk ratio for chronic pain treatment.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | KLS-GABA co-crystal showed a high gastric solubility and systemic exposure of ketoprofen in vivo. |
• | KLS-GABA co-crystal most effectively counteracted neuroinflammation in vivo. |
• | KLS-GABA co-crystal had the greatest therapeutic efficacy in neuropathic pain in vivo. |
• | KLS-GABA co-crystal has a high gastrointestinal tolerability. |
• | KLS-GABA co-crystal is a new multimodal potential therapeutic approach for chronic |
Keywords : Drug-drug co-crystal, Ketoprofen lysine salt, Gabapentin, Chronic pain, Neuropathic pain, Neuroinflammation
Plan
Vol 163
Article 114845- juillet 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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