Introduction

The treatment of chronic low back pain (cLBP) often involves multimodal pharmacologic and non-pharmacologic strategies. There remain shortcomings with these tools with regards to both effect size and side effects.

Areas covered

In an effort to better address cLBP, anti-nerve growth factor (NGF) monoclonal antibodies (mAbs) are nearing marketing approval. This class of medications has been primarily evaluated for osteoarthritis, but are being examined at higher doses for use in cLBP. We review the efficacy of this class in treating LBP as well as their potential side effects based on nine phase II or III published clinical trials. Five trials evaluated Tanezumab and four trials evaluated Fasinumab, with seven trials evaluating nonspecific LBP, one evaluating sciatica related cLBP, and one evaluating vertebral fracture related cLBP.

Expert opinion

The results of available clinical trials indicate modest effectiveness with regard to reduction of pain in the low back, and improved functionality, compared to placebo in keeping with the effect size of other pharmacologic treatment modalities. Rapidly progressive osteoarthritis was infrequently reported. However, the continued observation of this serious side effects warrants careful patient selection and balancing the risks and benefits of anti-NGF mAbs in treating cLBP.

中文翻译：

---

用于治疗腰痛的抗神经生长因子抗体。

介绍

慢性腰痛 (cLBP) 的治疗通常涉及多模式药物和非药物策略。这些工具在效果大小和副作用方面仍然存在缺陷。

涵盖的领域

为了更好地解决 cLBP，抗神经生长因子 (NGF) 单克隆抗体 (mAb) 接近上市批准。这类药物主要用于评估骨关节炎，但正在以更高的剂量进行检查以用于 cLBP。我们根据已发表的九个 II 期或 III 期临床试验回顾了此类治疗 LBP 的疗效及其潜在副作用。五项试验评估了 Tanezumab，四项试验评估了 Fasinumab，其中七项试验评估了非特异性 LBP，一项评估了与坐骨神经痛相关的 cLBP，一项评估了椎骨骨折相关的 cLBP。

专家意见

现有临床试验的结果表明，与安慰剂相比，在减轻腰部疼痛和改善功能方面的效果适中，与其他药物治疗方式的效果大小保持一致。很少报道快速进展的骨关节炎。然而，继续观察这种严重的副作用需要仔细选择患者并平衡抗 NGF mAb 治疗 cLBP 的风险和益处。