New Compound, BIIB074, May Ease Trigeminal Neuralgia Pain with Fewer Side Effects, Study Says

New Compound, BIIB074, May Ease Trigeminal Neuralgia Pain with Fewer Side Effects, Study Says

Treatment with a compound called BIIB074 shows promise in reducing pain caused by trigeminal neuralgia — a  condition that occasionally affects multiple sclerosis (MS) patients — with few side effects, a new clinical trial finds.

The Swiss study, “Safety and efficacy of a Nav1.7 selective sodium channel blocker in Titrigeminal neuralgia: a double-blind, placebo-controlled, randomised withdrawal phase 2a trial,” appeared in the journal The Lancet Neurology.

Trigeminal neuralgia refers to sharp, acute pain in the teeth or face. It is caused by irritation of the trigeminal nerve, which stimulates the face, parts of the scalp and the oral cavity. Simple stimuli can irritate nerves, like touch, applying makeup, showering, talking, or even feeling a gust of wind.

Current treatment includes blockers of sodium channels such as carbamazepine and oxcarbazepine, but these drugs inhibit the channels whether they are active and causing pain or not, and for this reason have unwanted side effects.

The Phase 2a trial (NCT01540630), conducted by the Center of Dental Medicine at the University of Zurich in Switzerland, involved 67 adults with trigeminal neuralgia. Researchers investigated the efficacy and safety of BIIB074, a blocker of sodium channels known to be responsible for pain and intensity.

Patients were initially assigned to receive oral BIIB074 (150 mg) three times a day for 21 days. Responsive patients were then randomly assigned to receive BIIB074 or placebo for up to 28 days in a second phase. The study’s endpoint was the difference between groups in the number of patients classified as treatment failures during the second phase.

Of the initial 67 patients, 29 entered the study’s second phase; 15 received BIIB074 treatment and 14 received a placebo. Five patients in the BIIB074 group and nine in the placebo group were classified as treatment failures.

The patients tolerated BIIB074 without severe or serious adverse events. Reported side effects occurring in the study’s first part included headache and dizziness, whereas in the second part, the most common side effects were headache, pyrexia (fever), nasopharyngitis, sleep disorder and tremor.

Although treatment failure was not significantly lower in the BIIB074 group compared to the placebo group, researchers believe more studies are needed to measure the effect of BIIB074 on patients with trigeminal neuralgia.

BIIB074 acts when its target sodium channel is active; the more active, the more pain, but the greater is the treatment’s effect. That runs contrary to the other blockers, which inhibit channels even when they’re inactive – hence, the potential for unwanted side effects.

“Unlike conventional drugs, which often cause tiredness and concentration problems, BIIB074 was not only effective, but also very well tolerated,” Dominik Ettlin, one of the study’s authors, said in a news release. “We will now test the new substance in a lot more subjects during the next study phase, which will reveal whether the new hope for more effective pain relief is justified.”

About 13 in 100,000 Americans are diagnosed with trigeminal neuralgia every year, and the condition affects more women than men. Around 1 percent of all MS patients develop trigeminal neuralgia.

10 comments

  1. Janice Gundersen says:

    I have suffered for many many years with TN. It is unbearable and nothing helps .Over 25 years of being in pain and it has robbed my life. If there is.help please let me know.

    • Nanci says:

      I have had 2 brain surgeries and radiation and I still have TN. I just starting going to an “upper cervical chiropractor” and I am not sure if it is helping or if I am in remission but they know what it is and it is very promissing. I looked on youtube and a guy in North Carolina has helped 1,000 patients, so I looked in L.A. (close to where I live) and he is also doing it and helping patients (since no one ever knows what it is either)

      • Nanci says:

        Oh, look at my comment above about “upper cervical chiro.” It is better than Lyrica for me. I read the next comment about Lyrica. I am on it now and it is very strong and works with my other drugs to get rid of the pain (Lyrica, 400 mg= 100 2 x day & 200 at night, 50 mg Nucynta 3 x day but it is a muscle pain reliever? & Baclofen – I forget the milligrams- 10 3 x day? & carbamezapine 800 a day. One is an opiate & 1 is a narcotic & anti-seizure meds. I have all the bad side effects. I can’t DRIVE, I have big time problems going to the bathroom, I can’t remember anything & I always fall asleep. My pain doctor says Nucynta is something that is probably not doing anything because it is a muscle relaxer. I am going off my meds now & becoming very clear & able to do more things with my body (- I have MS too) I am very hopeful that I’ll be off of them soon. This upper cervical I think is helping

      • Desiree Rodriguez says:

        Hi my name is Desiree and I was recently diagnosed with TN and wanting to know what Dr you are going to for upper Cervical Tx ?

  2. Derrick says:

    Janice, after tons of tegretol, trileptol, and even glycerol rhizotomy (with only temporary relief), neurologist rx’d lyrica. I am now taking (450 mg) Lyrica a day, alongside (450-600 mg) oxcarbazapene, and it is finally under control with only slight twinges! I have my eyes on several other avenues if it gets worse, but at least for now it is tolerable. Hope this helps!

  3. Luz Perez says:

    I am being treated with elavil 25mg and 10mg. For a time it was controlled but now I am taking a quimiotherapy that one of its effectcts is neuropathy. I am worried because trigeminal neuragia pain is horrible and its begining to rise again.

  4. Kat Andrews says:

    So now that the meds that I was taking have shut down my kidneys I am only on CBDs and THCs and it works to a degree. I am constant pain now for one year straight. I have carried this beast for 37 years, and I am so sick of it.

    • Nanci says:

      Look at my comment above about “upper cervical chiropractor.” I also wear a “glutathione” patch from “Lifewave” that is good for your liver & many other things. I have never had to do anything with my liver & I am on so many drugs (as I wrote about in my next comment)

  5. Jeanne Anthony says:

    I have had TN for 8 years. For months at a time it is sporadic. Then for months at a time it is chronic pain with periods of intense pain. I look forward to a new treatment. Now I take tegretol and it takes the edge off the intense pain. Makes me lethargic but better than unbearable pain. Unless a person has TN they cannot relate to the level of pain or the way it interferes with your life.

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