Various Doses of Tanezumab in the Management of Chronic Low Back Pain (CLBP): A Pooled Analysis of 4,514 Patients

Abstract

Chronic low back pain (CLBP) is a persistent and debilitating condition characterized by pain and discomfort in the lower back region that lasts more than 12 weeks. This review aims to determine the efficacy and safety of various doses of tanezumab for managing CLBP. The present meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Intervention standards. We searched multiple databases, including PubMed, Cochrane Library, Excerpta Medica Database (EMBASE), Scopus, and Web of Science, to identify randomized controlled trials comparing tanezumab to placebo or different dosage regimens for CLBP in adult patients. The primary outcome was the mean change in low back pain intensity (LBPI) score baseline to the end of treatment. Secondary outcomes included adverse events and the degree of disability or impairment. A total of six studies were included in the meta-analysis. Analysis of the data showed that tanezumab 5 mg significantly reduced LBPI compared to placebo at all time points (mean deviation (MD) ranging from -0.31 to -0.5). Similarly, tanezumab 10 mg showed a significant reduction in LBPI compared to placebo at all time points (MD ranging from -0.48 to -0.84). However, tanezumab 5 mg showed significantly less reduction of LBPI compared to 10 mg at two, four, eight, and 12 weeks (MD ranging from 0.19 to 0.32). These findings suggest that tanezumab is an effective treatment for CLBP, with 5 mg and 10 mg doses providing clinically meaningful reductions in LBPI.

Keywords: chronic low back pain (clbp); chronic pain management; systematic review and meta-analysis; tanezumab; treating low back pain.

Figure 1. PRISMA flow chart depicting the process of study selection

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; EMBASE: Excerpta Medica Database

Figure 2. A traffic light plot of the included studies

Sources: [14,16-17,25-27]

Figure 3. A forest plot comparing the LBPI of tanezumab 5 mg and placebo

LBPI: low back pain intensity; CI: confidence interval, SD: standard deviation, IV: inverse variance Sources: [16-17]

Figure 4. A forest plot comparing LBPI of tanezumab 10 mg and placebo

LBPI: low back pain intensity; CI: confidence interval, SD: standard deviation, IV: inverse variance Sources: [16-17]

Figure 5. A forest plot comparing LBPI of tanezumab 5 mg and tanezumab 10 mg

LBPI: low back pain intensity; CI: confidence interval, SD: standard deviation, IV: inverse variance Sources: [16-17,25]

Figure 6. A forest plot of the change in RMDQ for tanezumab 5 mg and placebo

LBPI: low back pain intensity; CI: confidence interval, SD: standard deviation, IV: inverse variance; RMDQ: Roland Morris Disability Questionnaire Sources: [16-17]

Figure 7. A forest plot of the change in RMDQ for tanezumab 10 mg and placebo

LBPI: low back pain intensity; CI: confidence interval, SD: standard deviation, IV: inverse variance; RMDQ: Roland Morris Disability Questionnaire Sources: [16-17]

Figure 8. A forest plot of the change in RMDQ for tanezumab 5 mg and tanezumab 10 mg

LBPI: low back pain intensity; CI: confidence interval, SD: standard deviation, IV: inverse variance; RMDQ: Roland Morris Disability Questionnaire Sources: [16-17,25]

Figure 9. A forest plot of any adverse events outcomes

CI: confidence interval, M-H: Mantel-Haenszel Sources: [16-17,25-26]

Figure 10. A forest plot of serious adverse events outcomes

CI: confidence interval; M-H: Mantel-Haenszel Sources: [16-17,25-26]

Figure 11. A forest plot of discontinuation due to adverse events

CI: confidence interval; M-H: Mantel-Haenszel Sources: [16-17,25-26]

Figure 12. A forest plot of the arthralgia outcomes

CI: confidence interval; M-H: Mantel-Haenszel Sources: [16-17,25-26]

Figure 13. A forest plot of paresthesia outcomes

CI: confidence interval; M-H: Mantel-Haenszel Sources: [16-17,25-26]