In MedPanel Summit, Leading Pain Experts Name Cannabinoids Among Most Promising Approaches to Treating Neuropathic Pain, Assert That Sociopolitical Climate Will Hamper Drug Approvals
21 June 2006
Cannabinoids, chemical agents found in the marijuana plant and endogenous to the human body, are the most promising approach to treating a common type of pain, according to an elite group of pain specialists convened by MedPanel to discuss the challenges and future of treating neuropathic (nerve injury) pain. Despite widespread acknowledgement of the inadequacy of current therapies for this type of pain, the specialists view Food and Drug Administration (FDA) approval of a cannabinoid drug as a thorny process that will be hampered by politics, prejudice and a lack of education on the part of the FDA, Drug Enforcement Agency (DEA) and general public concerning the nature of cannabinoid agents. While it is difficult to estimate the number of people suffering from neuropathic pain, the condition is frequently seen in patients with diabetes, cancer, carpal tunnel syndrome, HIV, diseases of the central nervous system such as multiple sclerosis and Parkinson’s disease, and in certain post-surgical populations.
“During the summit we asked the group to respond to data pertaining to several novel drug therapies and classes of agents under study, and at the conclusion of the meeting they told us that cannabinoids’ potential for a strong analgesic affect, broad action on the central nervous system, reduced side effects and use in combination with other therapies is more exciting to them than several other investigational approaches,” said Matt Fearer, Senior Vice President, Content Development for MedPanel. “It appears, however, that an unfortunate sociopolitical climate could delay or prevent the approval of potentially valuable therapies for millions of people suffering from neuropathic pain,” he added.
To facilitate a cannabinoid drug approval process, some of the specialists recommended that manufacturers develop drug therapies that act selectively — that is, on a few specific rather than on several — cannabinoid receptors in the body. The group agreed that it would be important to involve FDA in clinical trial design, share early trial data, and engage in education with DEA and the general public to overcome the perception that cannabinoids are the same as marijuana.
The summit participants concurred that if approved for prescription use in the United States, a cannabinoid agent would likely be regulated (“scheduled”) by the DEA, as are opioids and certain anti-convulsants — two of the most commonly used types of neuropathic pain therapies.
In considering challenges to developing therapies for and treating neuropathic pain, the group frequently noted the need for more effective therapies, better animal models of pain, new diagnostic tools, and improved clinical trial design — including selection of an appropriate study population and new methods to address bias such as the placebo effect.