Two Drugs Are Coming to Help – Without the Opioid Addiction Risk
Since the population of America is aging at an exponential rate – the number of Americans ages 65 and older is projected to more than double by 2060 – and in keeping with the osteoarthritis/non-narcotic chronic pain relief theme of our last blog entry, let’s talk about Tanezumab and Fasinumab as they relate to aging and chronic pain.
Over 27 million Americans suffer from osteoarthritis and 23 million live with chronic low back pain – and many of these individuals don’t get significant pain relief from their conditions. Pfizer, in partnership with Eli Lily, has been working on a drug called Tanezumab, which is a nerve growth factor (NGF) inhibitor.
How Tanezumab Relieves Pain without Opioids
As a monoclonal antibody, Tanezumab selectively targets, binds to, and inhibits NGF. NGF regulates pain signals, increasing in the body when there is injury, inflammation, and chronic pain. Because Tanezumab inhibits NGF, pain signals may be prevented from reaching the brain and spinal cord. This is the first such drug “fast tracked” by the FDA, which makes clear there is considerable promise for pain relief.
On July 18, 2018, Pfizer and Eli Lilly announced positive results from a Phase 3 clinical trial evaluating tanezumab for the treatment of osteoarthritis (OA) pain. There was only a 1% discontinuation rate due to adverse events. Patients who took two doses of Tanezumab separated by 8 weeks reported significant improvements in their pain levels and physical function.
In March of 2020, the U.S. Food and Drug Administration (FDA) accepted for review a Biologics License Application (BLA) for Tanezumab. This means the Tanezumab trial data (to date) meets regulatory guidelines, and it’s that much closer to public availability.
If this promising drug is approved, it will be the first in a new class of non-opioid pain relievers. That right there gives those taking opioids, or who are not getting enough pain relief from current medications, a healthy alternative that doesn’t carry the risk of addiction.
Currently, it shows promise in human trials, as of 2021:
Long-Term Safety and Efficacy of Subcutaneous Tanezumab Versus Nonsteroidal Antiinflammatory Drugs for Hip or Knee Osteoarthritis – PubMed
Fasinumab: Another Non-Opioid Pain Reliever Under Testing
Fasinumab, another drug in the same class that you may hear about, is made by Regeneron and has also been in clinical trials. Unfortunately, the company had to halt clinical trials in early 2018 after a monitoring committee found a negative risk-benefit outcome. Regeneron has had issues with high doses of the drug in the past, as well.
They restarted clinical trial in 2019 with a lower dose of the medication, as recommended by the monitoring committee. The National Library of Medicine published results from a trial in September 2019, testing Fasinumab on keep & hip pain caused by osteoarthritis. Results showed “statistically significant and clinically important reductions in pain compared to placebo…without any clear dose dependence.”
The trial demonstrates that Fasinumab DOES show promise.
A Nature.com article backs this up with its late 2020 article (subscription required):
Fasinumab effective for chronic low back pain – Nature Reviews: Rheumatology
Non-Opioid, Non-Addicting Pain Relief Options are Coming
A huge benefit of these medications and others like them is that, should they be approved for use, they hold the potential to reduce Americans’ intake of opioid-based medications. The medications we use now have high rates of misuse among chronic pain sufferers, leading to terrible addictions. Non-addicting options give use the same or better pain relief than the opioids, with much greater safety for aging Americans.
UPDATED JUNE 1, 2022