Investigators have found that the monoclonal antibody tanezumab successfully relieved chronic low back pain, one of the leading reasons people seek medical care and the number 1 cause of disability globally. “This demonstration of efficacy is a major breakthrough in the global search to develop nonopioid treatments for chronic pain,” said John Markman, MD, lead author of the study, in a statement. According to a press release, investigators have increasingly found that certain proteins in the bloodstream can heighten the sensitivity of cells in the nervous system to pain. Nerve growth factor (NGF) proteins may contribute to more intense and chronic back pain in some individuals, and as an NGF inhibitor, tanezumab may help. This is the first study to show long-term chronic low back pain relief with a single dose of tanezumab delivered subcutaneously once every 2 months and was conducted in 191 sites across 8 countries. The enrolled patients with chronic low back pain did not find relief with at least 3 previous types of pain medication, including opioids, and were considered “difficult to treat.” The investigators excluded patients with symptoms, signs, and x-ray evidence of moderate-to-severe osteoarthritis. Notably, tanezumab has not been associated with the often-serious adverse effects that are frequently seen with opioids or nonsteroidal anti-inflammatory drugs (NSAIDs). NGF inhibitors have, however, been associated with joint problems, which are sometimes serious enough to require joint replacement. In order to manage this, the investigators followed study participants for an extended period and concluded that there was a low rate of serious joint problems requiring joint replacement. “In the future, clinicians may have to weigh the different risks of lumbar fusion surgery, chronic opioid use, or NSAIDs against the unique risks of a rare but rapidly progressive form of joint problem associated with blocking nerve growth factor,” Markman said. “I expect that the tradeoffs between benefit and risk will be different for osteoarthritis than for chronic low back pain.” New Therapy Reduces Chronic Low Back Pain in Large International Study [news release]. University of Rochester Medical Center; June 19, 2020. https://www.urmc.rochester.edu/news/story/5669/new-therapy-reduces-chronic-low-back-pain-in-large-international-study.aspx#:~:text=A%20new%20study%20hasfound%20that,one%20cause%20of%20disability%20worldwide. . Accessed July 6, 2020.