HCN-pain
Research type
Research Study
Full title
The role of HCN channel receptor in neuropathic pain:an open-label, single arm study of ivabradine in patients with peripheral neuropathic pain
IRAS ID
215720
Contact name
Michael Lee
Contact email
Duration of Study in the UK
1 years, 2 months, 28 days
Research summary
Neuropathic pain is pain that arises as a result of nerve damage. Nerves can be damaged by accidental trauma, or inadvertent by surgery. Diseases like diabetics or shingles can also cause nerve damage. Not every patient who has nerve damage experienced pain, but those who do suffer from long-term pain that is very challenging and difficult to treat.
Scientists in Cambridge have discovered that HCN-2 receptor is necessary for pain caused by nerve damage but the finding has not been confirmed in humans. Drugs have yet to be developed that block the HCN-2 receptor specifically. However, there is already a drug licensed that blocks all types HCN receptors (HCN 1 to 4) called ivabradine. It is currently used to cause a slowing of heart rate, which is useful for
patients with chest pain for heart disease. In this study, we will be using it test whether blocking HCN channels with ivabradine will affect nerve pain in patients. We would be adjusting the dose of ivabradine according to heart rate response because basic science data (in mice) tells us that pain relief occurs with heart-rate lowering effects of the drug. Effects on heart rate takes a while to develop and we plan to prescribe ivabradine, starting with the low dose and increasing slowly over 6-12 weeks, according to heart rate. We will be looking for a drop in pain scores recorded using an electronic diary before and after drug administration. We will not be comparing Ivabradine to a placebo here because blinding is difficult, and we do not as yet know if we can achieve the degree of HCN blockade (revealed by effects of heart rate) required for analgesia in patients with nerve pain but who do not have any heart disease and generally healthy.REC name
London - Bromley Research Ethics Committee
REC reference
16/LO/1901
Date of REC Opinion
8 Dec 2016
REC opinion
Further Information Favourable Opinion