Clinical Issues in Chronic Pain: Debates and Discussions About Therapeutically Targeting Nerve Growth Factor Signaling

Chronic pain affects 100 million Americans and has significant health and socioeconomic repercussions.1 Appropriate pain management can improve patient quality of life and overall outcomes and also reduce health care costs.1 Although nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are often prescribed to manage chronic pain, both analgesic classes are associated with risks and are not appropriate for all patients.2-4 The search for additional treatment options with novel mechanisms of action has resulted in some focus on nerve growth factor (NGF) as a potential therapeutic target.5 In this Clinical Issues™ program, an expert panel will examine the pathophysiologic roles of NGF in osteoarthritis and low back pain, and clinical trial data for emerging anti-NGF therapies.6,7 Learners will leave this engaging discussion with an increased understanding of current and future techniques for pain management.

References

1. Institute of Medicine Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: National Academies Press; 2011. https://www.ncbi.nlm.nih.gov/books/NBK92519/. Accessed March 21, 2018.

2. Dowell D, et al. CDC [Centers for Disease Control and Prevention] Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. MMWR Recomm Rep. 2016;65(1):1-49.

3. Johnsen SP, et al. Risk of hospitalization for myocardial infarction among users of rofecoxib, celecoxib, and other NSAIDs: a population-based case-control study. Arch Intern Med. 2005;165(9):978-984.

4. Whelton A. Renal and related cardiovascular effects of conventional and COX-2-specific NSAIDs and non-NSAID analgesics. Am J Ther. 2000;7(2):63-74.

5. Malfait AM, Miller RJ. Emerging targets for the management of osteoarthritis pain. Curr Osteoporos Rep. 2016;14(6):260-268.

6. Denk F, et al. Nerve growth factor and pain mechanisms. Annu Rev Neurosci. 2017;40:307-325.

7. Miller RE, et al. Current status of nerve growth factor antibodies for the treatment of osteoarthritis pain. Clin Exp Rheumatol. 2017;35 (suppl 107[5]):85-87.