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Drugs that block voltage-gated sodium channels (NaVs) have utility in treating conditions including pain, epilepsy, and cardiac arrhythmias and as anesthetics ( Lancet Neurol. 2010 9 413 424 ; Expert Opin. Ther. Pat. 2010 20 755 779 ). The identification of compounds with improved efficacy and safety is a key aim for the discovery of improved NaV blocking drugs ( Comprehensive Medicinal Chemistry III; Elsevier, 2017; pp 131−175 ). We report the identification of a novel class of brain penetrant and voltage-gated sodium channel blockers, leading to the discovery of vixotrigine, a use-dependent sodium channel blocker with activity in in vivo models of pain. Vixotrigine has excellent physiocochemical properties for drug development, and both preclinical and clinical data support a safety profile suitable for potential use in neuropathic pain and other conditions. It has shown efficacy in a Phase II study for pain associated with trigeminal neuralgia.