Could a New Medicine Hold the Key to Back Pain Relief?

Imagine being able to take a pill and be free of lower back pain for months. That’s what a new nonopioid pain reliever might offer, but its relief might come with a significant price.

According to a study published in the June 19th issue of the journal Pain, a new drug called tanezumab, a monoclonal antibody, is specifically engineered to stop chronic lower back pain by blocking nerve growth factor, the protein that actually turns on our sensation of pain.

The drug is manufactured by Pfizer and Eli Lilly and Company, and it is currently undergoing phase 3 clinical testing in a clinical trial with 1,800 participants, 600 of whom received an opioid drug, 600 of whom were given 1 or 2 doses of tanezumab and 600 of whom received placebo. Lead researcher Dr. John Markman, professor of neurosurgery and neurology at the University of Rochester School of Medicine in New York, expressed excitement about the new drug.

“It appears that we are on the cusp of developing new drugs, which treat chronic pain by turning down the sensitivity of the nervous system, which is a whole new way of approaching the problem of chronic pain,” he said. “This is very important because we haven’t really had drugs with a new way of affecting chronic pain developed in maybe 100 years.”

The tests revealed that the higher dose of tenezumab reduced pain and improved function, offering alternatives to current non-surgical medication offerings that include nonsteroidal anti-inflammatory drugs and opioid painkillers. Both of these conservative approaches have shortcomings, though others including massage, exercise and steroid injections have proven helpful. Surgery is also a common alternative, including minimally invasive microdiscectomy and spinal fusion surgery.

Tanezumab is not currently available. It is undergoing scrutiny by the U.S. Food and Drug Administration. If it is approved it will be administered as an injection given every two months. Though it does not have the risk of addiction that comes with opioid medications or the gastrointestinal side effects that come with non-steroidal anti-inflammatories, researchers acknowledge concern about another potential side effect found during another clinical study examining the drug’s use for the treatment of osteoarthritis: joint deterioration. Patients who experience this adverse effect may end up requiring joint replacement surgery. That study found that patients experienced significant pain relief after just four months.

The search for an effective drug-based approach to chronic lower back pain has been going on for a very long time, but has proven challenging because of troubling side effects. Dr. Yili Huang, director of pain management at Northwell Health Phelps Hospital in Sleepy Hollow, N.Y. said:

Any potentially effective new treatment is truly exciting, especially because those that are currently available act on anti-inflammatory or opioid receptors and have been found to be open to long-term side effects including cardiovascular disease, addiction, and kidney and liver disease. Treating a new target along the pain pathway can open the door to potentially safer and more effective treatments.”

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