Novel injectable analgesic delivery system for musculoskeletal pain management

项目摘要 肌肉骨骼疾病的急性发作（即，术后痛觉过敏，骨关节炎，枕神经痛， 和下背部疼痛）表现为疼痛强度增加。目前，阿片类药物是用来治疗这些耀斑的- 这使得肌肉骨骼疼痛成为阿片类药物处方最常见的原因之一。吸毒过量，虐待， 处方阿片类药物的转移和死亡在美国已经达到流行病的比例， 相关的医疗费用超过7000亿美元。我们的长期目标是开发替代的、不成瘾的 治疗肌肉骨骼疾病突发的干预措施。我们提出的研究旨在开发可注射的 通过将局部麻醉剂与低剂量抗炎/镇痛剂组合的长效麻醉剂制剂 疼痛调节剂和使用工程载体的这些药物的持续递送。初步研究显示， 协同药物组合与可注射水凝胶/脂质纳米胶囊结合潜力 纳米复合物延长局部镇痛。我们建议评估临床使用的皮质类固醇以及 新出现的镇痛疼痛调节剂与罗哌卡因联合，以鉴定协同药物组合。 将研究扩散-和降解-控制释放过程以用于持续递送本发明的药物组合物。 镇痛疼痛调节剂，以防止神经周围炎症和神经毒性。在体内评估的 将通过以下行为和电生理学检查来评估制剂的有效性和安全性 大鼠模型的反应。一种可注射长效制剂，可在门诊设施中给药 并且可以维持局部痛觉减退效应7-14天，将显著提高那些 患有发作，但没有阿片类药物治疗的可怕后果。

Project Summary Acute flare-ups of musculoskeletal conditions (i.e., post-operative hyperalgesia, osteoarthritis, occipital neuralgia, and lower back pain) present as increased intensity of pain. Currently, opioids are prescribed to treat these flare- ups, making musculoskeletal pain one of the most frequent reasons for opioid prescriptions. Overdoses, abuses, diversions, and deaths from prescription opioids have reached epidemic proportions in the United States with associated healthcare costs of over $700 billion. Our long-term objective is to develop alternative, non-addictive interventions to treat flare-ups of musculoskeletal conditions. Our proposed research aims to develop injectable long-acting anesthetic formulations by combining local anesthetics with low doses of anti-inflammatory/analgesic pain modulators and sustained delivery of these drugs using engineered carriers. Preliminary studies showed the potential of synergistic drug combinations in conjunction with injectable hydrogel/lipid nanocapsule nanocomposites in prolonging local analgesia. We propose to evaluate clinically used corticosteroids as well as emerging analgesic pain modulators in conjunction with ropivacaine to identify the synergistic drug combinations. A diffusion- and degradation-controlled release process will be investigated for the sustained delivery of the analgesic pain modulators to prevent perineural inflammation and neurotoxicity. The in vivo assessment of the efficacy and safety of the formulations will be performed by following the behavioral and electrophysiological responses in rat models. An injectable long-acting formulation, which can be administered in an outpatient facility and can sustain local hypoalgesic effects for 7-14 days, would significantly enhance the quality of life for those suffering from flare-ups without the dire consequences of opioid therapy.