Tanezumab offers an exciting new class of analgesics targetting nerve growth factor  that has the potential to change the treatment of pain particularly low back ache and osteoarthritis.

Acute and chronic pain states remain challenging to treat, yet there are several classes of drugs as NSAIDs, opioids, and neuropathic agents, but they may result in poorly tolerated side effects. Anti-NGF antibodies are a novel therapy in pain management and have shown promise in the treatment of conditions that are currently poorly treated.

             To use anti-NGF antibodies for different pain conditions, it has shown to have some benefit on chronic low back pain and osteoarthritic pain relief and functional improvement, but additional data are necessary to determine efficacy and safety. Further investigations are required as the data are lacking for the utility of the drug in postherpetic neuralgia. Other potential indications include treatment for interstitial cystitis, prostatitis, and pancreatitis. Continued attention to safety issues associated with tanezumab will also help determine its utility.

           The adverse effects associated with cyclooxygenase-2 inhibitors and NSAIDs were not demonstrated in patients on tanezumab therapy. Neither does the novel drug appear to have any effects on the respiratory or central nervous system or raise concerns regarding abuse liability.Adverse events (AEs) such as transient arthralgias, paresthesias, and hypoesthesia were noted in patients receiving tanezumab.However, the AEs were fewer compared to patients receiving opioids and mixed results were obtained when comparing to NSAIDs.

            Tanezumab studies included placebo-controlled and active-controlled (comparing to naproxen and oxycodone) studies. Table demonstrates the different doses of tanezumab used for the treatment of patients with OA: 2.5 mg, 5 mg, 10 mg in Phase II trials and 10 μg/kg, 25 μg/kg, 50 μg/kg, 100 μg/kg, and 200 μg/kg in Phase III trials. The doses used for chronic low back pain ranged from 5 mg to 20 mg every 8 weeks or a single shot of intravenous 200 μg/kg.