Healthy Clinical Trial
Official title:
The Pharmacogenetics of Oxycodone Analgesia in Human Experimental Pain Models
Thirty-two healthy volunteers will be submitted to experimental pain and on the 2 study days receive Oxycodone 20 mg po vs. placebo. Half of the volunteers will be poor metabolizers according to CYP2D6 genotype and half will be extensive metabolizers (EM) and have an enzyme with normal function. The study hypothesis is that PM will experience less pain relief than EM.
Oxycodone is a semi-synthetic opioid with an analgesic effect in the postoperative pain
management comparable to morphine. Oxycodone is N-demethylated by CYP2D6 to its active
metabolite oxymorphone, a potent μ-receptor agonist. A genetic polymorphism divides a
Caucasian population into two groups: 8% with an enzyme lacking activity, poor metabolizers
(PM) and the rest with normal CYP2D6 activity, extensive metabolizers (EM).
Many different, single nucleotide polymorphisms (SNPs) are responsible for interindividual
differences in the effect of opioids. Among these are the A118G SNP in the μ-receptor gene
OPRM1 and the C3435T and G2677T/A SNPs in the MDR-1 gene of P-glycoprotein. P-glycoprotein
is responsible for the absorption, excretion and transport of many drugs including opioids
over the blood-brain barrier.
Electrical stimulation and cold pressor test are among the most well defined and evaluated
human experimental pain models. The 32 volunteers will be submitted to the tests before and
1, 2, 3 and 4 hours after medicine intake.
To determine the plasma levels of Oxycodone and its metabolites blood will be drawn after
each pain test. Also the CYP2D6 genotype and the above mentioned SNPs will be determined
from the blood samples.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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