Capsaicin in the treatment of osteoarthritis

Source: U.S - China drug source January 3, 2018 [news event]: centrexion therapeutics, led by former Pfizer president Jeff Kindler, received US $67 million today to support its two phase III clinical trials of osteoarthritis injected with capsaicin preparation cntx-4975 In one trial, a single dose of cntx-4975 will be used, while in the other trial, two doses of cntx-4975 will be given at 6-month intervals Cntx-4975 is also ready to enter the phase III clinical trials of Morton neuroma pain and animal pain relief, but this financing only supports OA trials [drug source analysis]: centrexion was founded in 2013 It is a small enterprise with only a dozen people But it's a small and sophisticated business, and there are a few industry leaders besides the Kindle Kindler, a former Pfizer CEO, was fired by the board of directors in an airport conference room in 2006 after a phase III clinical fiasco of torcetrapib, a CETP inhibitor At that time, many people attributed the failure to the fact that kinder didn't know how to make drugs, because he was the CEO of McDonald's and Boston roast chicken before, but the accusation was unfair New medicine is a complex industry, no one can understand anything, everyone can only touch a small part of the elephant Capsaicin is an activator called TRPV1, or capsaicin receptor It has a long history to use capsaicin to relieve pain, but the effect is slight Cntx-4975 is a super pure synthetic capsaicin (trans isomer) and is injected into bone and joint with a special injection device Cntx-4975 is a peripheral drug, which blocks pain signals from pain fibers to the center, so it may avoid central side effects Although the half-life of cntx-4975 is very short, a single injection can last for 6 months because these pain fibers regenerate before retransmitting pain signals In June this year, cntx-4975 showed extraordinary efficacy in a phase II OA clinical trial called triumph, which is the main basis of this financing The placebo effect of OA is very high, so it is difficult to make positive data Although the effect of placebo was also significant in the trimph trial, the pain of 1 mg cntx-4975 injection was significantly lower than that of the placebo group at 12 and 24 weeks But cntx-4975 failed to reach the end point in a Morton neuromatodynia phase II clinical trial because of the high placebo effect in one of the trial centers Removing the data from this center, cntx-4975, significantly reduces pain, but this is a bit of self deception At present, morphine addiction in the United States has become a serious health crisis, and the death of morphine abuse has become the number one cause of death for young and middle-aged people So last year, President Chuan designated morphine abuse as a national health crisis Non steroidal, non addictive painkillers are one of the largest unmet medical needs in the United States Trvp1 antagonist used to be a pain relief target, but amg517, which was the first one to enter the clinic, had the side effect of increasing body temperature, so the development was terminated Capsaicin is a 200 year old drug, and cntx-4975 is a syringe driven new product similar to Epipen Epipen suffered a lot last year because of its price, so how to price cntx-4975 is also a problem Another promising OA drug is tanezumab, an anti NGF antibody However, because of its good analgesic effect, the patient's overuse of the joint will cause joint injury For many years, the market has not listed a new mechanism of painkillers.