Tanezumab: a selective humanized mAb for chronic lower back pain

Abstract

Chronic lower back pain is a significant disease that affects nearly 20% of the worldwide population. Along with hindering patients’ quality of life, chronic lower back pain is considered to be the second most common cause of disability among Americans. Treating chronic lower back pain is often a challenge for providers, especially in light of our current opioid epidemic. With this epidemic and an increased aging population, there is an imminent need for development of new pharmacologic therapeutic options, which are not only effective but also pose minimal adverse effects to the patient. With these considerations, a novel therapeutic agent called tanezumab has been developed and studied. Tanezumab is a humanized monoclonal immunoglobulin G2 antibody that works by inhibiting the binding of NGF to its receptors. NGF is involved in the function of sensory neurons and fibers involved in nociceptive transduction. It is commonly seen in excess in inflammatory joint conditions and in chronic pain patients. Nociceptors are dependent on NGF for growth and ongoing function. The inhibition of NGF binding to its receptors is a mechanism by which pain pathways can be interrupted. In this article, a number of recent randomized controlled trials are examined relating to the efficacy and safety of tanezumab in the treatment of chronic lower back pain. Although tanezumab was shown to be an effective pain modulator in major trials, several adverse effects were seen among different doses of the medication, one of which led to a clinical hold placed by the US Food and Drug Administration. In summary, tanezumab is a promising agent that warrants further investigation into its analgesic properties and safety profile.

<p>Patterns of drug treatment in patients with osteoarthritis and chronic low back pain in Japan: a retrospective database study</p>

“…Both OA and chronic LBP (CLBP) are common health problems in Japan (prevalence of radiographic knee and hip OA: 55.6%8 and 2.4%;9,10 prevalence of CLBP in ages >50: 15.4%11). These diseases negatively impact the healthy aging of the present and future populations 12,13…”

Pain management for the neurosurgical patient in spinal procedures: overview of historic and new modalities

“…Cebranopadol is an opioid-like agent developed by Tris Pharma, which is not yet FDA-approved but has completed phase 3 trials. Cebranopadol is a mu opioid (MOP) receptor and nociceptin opioid peptide (NOP) receptor agonist (Figure 1) [54]. An abuse potential analysis developed by Tris Pharma suggests that cebranopadol has a lower potential for abuse than tramadol and oxycodone.…”

Druggable Targets and Compounds with Both Antinociceptive and Antipruritic Effects

“…In theory, this approach may attenuate chronic pain and itch. However, severe adverse effects, such as osteonecrosis, have been reported, which suggests great risk in the development of anti-NGF antibodies, and, thus, many of these developments were halted [ 187 , 188 ].…”