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Review
. 2024 Dec;14(12):641-651.
doi: 10.1080/17581869.2024.2442292. Epub 2024 Dec 18.

Novel non-opioid analgesics in pain management

Tariq G Pulskamp  1 , Lucy M Johnson  1 , Daniel J Berlau  1
Affiliations
Review

Novel non-opioid analgesics in pain management

Tariq G Pulskamp et al. Pain Manag. 2024 Dec.

Abstract

Effective pain management has long been hindered by the limitations and risks associated with opioid analgesics, necessitating the exploration of novel, non-opioid alternatives. A comprehensive literature search was conducted using PubMed and Google Scholar during October and November 2024 to identify studies on emerging non-opioid pain management therapeutics. This review evaluates three promising classes of mechanism-specific therapeutics: nerve growth factor (NGF) monoclonal antibodies, transient receptor potential vanilloid 1 (TRPV1) antagonists, and selective sodium channel blockers. By targeting distinct pathways involved in pain sensation, these therapies aim to provide relief for various pain types, including chronic, inflammatory, and neuropathic pain, with potentially fewer side effects. Through a detailed analysis of their mechanisms of action and current evidence, this review highlights the clinical potential of each class, addressing both their efficacy and safety challenges. Ultimately, these emerging therapies represent significant advancements in non-opioid pain management, with the potential to reshape standard approaches to patient care.

Keywords: NGF monoclonal antibodies; TRPV1 antagonists; acute pain; chronic pain; mechanism-specific therapies; neuropathic pain; postoperative pain; sodium channel blockers.

Plain language summary

What is this article about?This article looks at new treatments for managing pain without using opioids. Opioids are strong painkillers but come with serious risks like addiction and other side effects. The treatments discussed in this article work by targeting specific parts of the body that cause pain. These include medicines that block certain proteins involved in pain, drugs that stop pain signals triggered by heat or acid, and medicines that focus on the body’s sodium channels, which play a role in pain signals.What were the results?The article reviews research on these treatments, showing that they work well for specific types of pain, but each has some side effects. For example, one treatment helps with chronic pain, like in arthritis, but can cause joint problems. Another helps with pain caused by heat or acid but might make people more sensitive to cold. A third type is useful for nerve pain or short-term pain but can lead to skin issues or affect the liver.What do the results mean?These treatments could give patients safer options for managing pain without the risks linked to opioids. However, researchers still need to find the best match between the type of pain and the right treatment. They also need to reduce side effects. Once these challenges are addressed, these therapies could offer better and more personalized pain relief for people who need it.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

References

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    1. Dowell D, Ragan KR, Jones CM, et al. CDC clinical practice guideline for prescribing opioids for pain — United States, 2022. MMWR Recomm Rep. 2022;71(3):1–95. - PMC - PubMed
    1. Centers for Disease Control and Prevention . Nonopioid therapies for pain: a clinical reference. 2022.[cited 2024 Nov 6]. Available from: https://www.cdc.gov/opioids

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