Glibenclamide for Neuropathic Pain in Multiple Sclerosis

This trial explores whether glibenclamide, taken as an oral extended-release pill, can safely alleviate nerve pain in people with multiple sclerosis (MS). Participants will receive either the medication or a placebo (a pill with no active ingredient) to help researchers assess glibenclamide's tolerance over time. This trial may suit individuals diagnosed with MS who frequently experience nerve pain. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants a chance to be among the first to receive this new treatment.

The trial requires that you stop taking any sulfonylurea medications, like glyburide or glipizide, at least 7 days before joining. If you're on these medications, you'll need to stop them to participate.

Research shows that glibenclamide, a drug commonly used for diabetes, is under investigation for its potential to alleviate nerve pain in people with multiple sclerosis. Other research has found glibenclamide to be generally safe for individuals who have had a stroke, with most experiencing no serious side effects.

This trial is in the early stages and primarily examines the safety and tolerability of glibenclamide for people with multiple sclerosis. While previous studies have not identified major safety concerns, this trial aims to determine its safety for this new application.

Most treatments for neuropathic pain in multiple sclerosis, like gabapentin and pregabalin, work by modulating neurotransmitter release. But glibenclamide works differently, targeting a specific pathway involved in inflammation and nerve damage. This unique mechanism of action could offer relief for patients who don't respond well to existing treatments. Researchers are excited because glibenclamide has the potential to not only alleviate pain but also address the underlying nerve damage. Additionally, the extended-release formulation aims to provide consistent pain management throughout the day with potentially fewer side effects.

Research has shown that glibenclamide might help with nerve problems by reducing damage to the protective covering of nerves, as observed in animal studies. In this trial, participants will receive either oral extended-release glibenclamide or a placebo. In stroke cases, glibenclamide is considered safe, although it did not prove very effective for that specific condition. Animal studies have found it works well with other treatments, which is encouraging for its use in combination therapies. While direct evidence for its use in nerve pain from multiple sclerosis is limited, the potential of glibenclamide to reduce nerve damage offers hope for managing this type of pain.¹²⁴⁵⁶