A Prospective, Open-label Study of Long-term Intrathecal Ziconotide for Chronic Nonmalignant Back Pain: A Case Report

Ziconotide is an N-type calcium channel (NCC) blocking conopeptide, acting primarily at the NCC-rich dorsal horn. Reported here is an early experience with intrathecal ziconotide in a 55-year-old man with chronic pain resulting from failed back surgery. All conservative and surgical treatments, in addition to IT morphine, failed prior to enrollment in a short-term, placebo-controlled trial testing ziconotide efficacy and safety. Following successful short-term treatment, the patient was enrolled in a long-term follow-up study. The dosing regimen, onset and resolution of adverse events, and improvement on the primary efficacy measure, the Visual Analog Scale of Pain Intensity, are discussed. Overall, the patient responded positively to ziconotide.