The efficacy of
neuropathic pain control remains unsatisfactory. Despite the availability of a variety of
therapies, a significant proportion of patients suffer from poorly controlled
pain of this kind. Consequently, new drugs and treatments are still being sought to remedy the situation. One such new drug is
mirogabalin, a selective
ligand for the α2δ subunits of voltage-gated
calcium channels (VGCC) developed by Sankyo group for the management of
neuropathic pain. In 2019 in Japan,
mirogabalin was approved for peripheral
neuropathic pain following the encouraging results of clinical trials conducted with diabetic peripheral
neuropathic pain (DPNP) and
postherpetic neuralgia (PHN) patients. The
ligand selectivity of
mirogabalin for α2δ-1 and α2δ-2 and its slower dissociation rate for α2δ-1 than for α2δ-2 subunits of VGCC may contribute to its strong
analgesic effects, wide safety margin, and relatively lower incidence of adverse effects compared to
pregabalin and
gabapentin. This article discusses the mechanism of action of
mirogabalin, presents data on its pharmacodynamics and pharmacokinetics, and reviews the available experimental and clinical studies that have assessed the efficacy and safety of the drug in the treatment of selected
neuropathic pain syndromes.