The chronic pain therapeutics landscape is experiencing significant expansion, with DelveInsight's latest pipeline report revealing more than 25 drug candidates under development by over 20 pharmaceutical companies. This surge in research and development activities signals a robust response to the growing demand for effective pain management solutions.
Key Pipeline Developments
Tris Pharma achieved a significant milestone in January 2025 with positive topline results from their ALLEVIATE-1 Phase III clinical trial. The study evaluated cebranopadol, a first-in-class dual-nociceptin/orphanin FQ peptide (NOP) receptor and μ-opioid peptide (MOP) receptor agonist, for moderate-to-severe acute pain following abdominoplasty surgery.
Mesoblast has made substantial progress with rexlemestrocel-L, their allogeneic stromal cell product. The company initiated patient enrollment in a Phase III trial focusing on chronic low back pain (CLBP) caused by inflammatory degenerative disc disease in July 2024. This advancement follows the FDA's grant of regenerative medicine advanced therapy (RMAT) designation for the treatment in February 2023, specifically when used in combination with hyaluronic acid.
Innovative Approaches in Development
Several promising candidates are advancing through various clinical stages:
- Adezunap (AP707) by Apurano Pharmaceuticals, administered as a sublingual spray, targets cannabinoid receptor CB1
- CNTX-6970 from Centrexion Therapeutics, an oral CCR2 receptor antagonist in Phase II trials
- NTM-006 by Neumentum, focusing on adenosine A3 receptor modulation
- CNTX 0290, another Centrexion therapy targeting somatostatin receptor subtype 4
ANANDA Scientific Inc. launched a notable clinical trial in October 2024, evaluating Nantheia™ ATL5, which combines cannabidiol (CBD) with delta-9-tetrahydrocannabinol (THC) using proprietary delivery technology. This study specifically targets patients with co-occurring opioid use disorder and chronic pain.
Market Impact and Unmet Needs
The increasing prevalence of chronic pain continues to drive market growth and investment in research. Current treatment approaches, including over-the-counter medications and prescription opioids, present limitations and risks, creating opportunities for novel therapeutic strategies.
The development pipeline reflects a diverse range of therapeutic approaches, from traditional small molecules to advanced biologics and cell therapies. This variety suggests a growing understanding of pain mechanisms and the need for multiple treatment options to address different patient populations and pain conditions.
Future Outlook
The robust pipeline, featuring multiple mechanisms of action and delivery methods, indicates a promising future for chronic pain management. As these candidates progress through clinical development, healthcare providers may soon have access to more targeted and potentially safer treatment options for their patients with chronic pain conditions.
