Osteoarthritis in 2016: Anti-NGF treatments for pain — two steps forward, one step back?
Chronic musculoskeletal pain remains a substantial challenge in clinical medicine despite the availability of a number of pharmacologic and non-pharmacologic treatments. In the past 10 years, attention has been focused on nociceptive pain, and in particular on β-nerve growth factor (NGF), a neurotrophin that is needed for normal development of the sympathetic nervous system and the sensory neurons responsible for nociception and temperature sensation. In individuals with musculoskeletal pain, treatment with NGF inhibitors can produce impressive improvements in joint pain and physical function; however, mild neurologic adverse events and cases of accelerated arthropathy have been reported in clinical trials, leading to suspension or delay of investigations into these agents. Both preclinical and clinical studies are ongoing to assess the mechanisms and effects of this novel effective analgesic treatment, and 2016 saw the publication of some notable results in this area.