New monoclonal antibody therapy reduces chronic low back pain

Written by Sharon Salt, Senior Editor

A large international study has demonstrated that tanezumab – a monoclonal antibody that inhibits nerve activity (NGF) – can provide long-term relief in patients with chronic low back pain.

Certain proteins that circulate in the bloodstream are increasingly being reported to heighten the sensitivity of cells in the nervous system to pain. NGF is believed to be one of these proteins and could explain why some individuals experience more intense and chronic back pain.

The study, which has been published in the journal Pain, was conducted in 191 sites across eight countries in North America, Europe and Asia. It is described as the first study to show that long-term relief for chronic low back pain can be achieved with a single dose of tanezumab administered subcutaneously once every 2 months.

“This demonstration of efficacy is a major breakthrough in the global search to develop non-opioid treatments for chronic pain. There were also improvements in function linked to the reduction in pain severity,” commented John Markman (University of Rochester Medical Center, NY, USA), lead author of the study.

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The participants with chronic low back pain who were included in this study were classified as ‘difficult-to-treat’, as they did not previously have relief from at least three different types of pain medication, including opioids. Those displaying symptoms, signs and X-ray evidence of moderate-to-severe osteoarthritis were excluded from the study.

Opioids and nonsteroidal anti-inflammatory drugs are routinely used to treat low back pain but are linked with often serious adverse side effects. Tanezumab, on the other hand, has not been associated with these adverse effects but this class of drug has been linked to joint problems – some of which were serious enough to require joint replacement. Due to this concern, the researchers followed participants for an extended period and determined that there was a low rate of serious join problems requiring joint replacement.

“In the future, clinicians may have to weight the different risks of lumbar fusion surgery, chronic opioid abuse, or nonsteroidal anti-inflammatory drugs against the unique risks of a rare but rapidly progressive form of joint problem associated with blocking NGF,” concluded Markman. “I expect that the tradeoffs between benefit and risk will be different for osteoarthritis than for chronic low back pain.”

Source: University of Rochester Medical Center. New therapy reduces chronic low back pain in large international study. Press release: www.urmc.rochester.edu