Why non-opi­oid pain drugs keep fail­ing — and what's next for the field

Illustration: Kim Ryu for Endpoints News

In 1938, Ri­ta Levi-Mon­tal­ci­ni was forced to move her lab in­to her bed­room in Turin, as Mus­soli­ni’s facist gov­ern­ment ex­pelled Jew­ish peo­ple from study­ing or work­ing in schools in Italy. Levi-Mon­tal­ci­ni, then just a few years out of med­ical school and us­ing sewing nee­dles as scalpels in her makeshift lab, would soon dis­cov­er nerve growth fac­tor, or NGF, in chick­en em­bryos.

Her dis­cov­er­ies formed the ba­sis of our un­der­stand­ing of the pe­riph­er­al ner­vous sys­tem and how cells talk to each oth­er, and Levi-Mon­tal­ci­ni went on to win the No­bel Prize in 1986. Much lat­er, NGF was hailed as a promis­ing tar­get for new pain ther­a­pies, with some an­a­lysts quot­ing an $11 bil­lion mar­ket. How­ev­er, the lat­est an­ti-NGF can­di­date, Pfiz­er and Eli Lil­ly’s tanezum­ab, was re­ject­ed by the FDA last year be­cause of a side ef­fect that dis­solved bone in some of its pa­tients.

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