Emerging therapies for neuropathic pain: new molecules or new indications for old treatments?

Neuropathic pain represents a highly unmet medical need because most of the available treatments have a modest efficacy or dose-limiting side effects. Hence, novel therapeutic perspectives are warranted. Many compounds acting on new pain targets are in preclinical or early clinical development. Only few clinical trials have suggested their clinical relevance in neuropathic pain. This concerns in particular NaV1.7 antagonists and angiotensin type II inhibitors. Another type of emerging drug therapy in neuropathic pain is represented by drugs largely used for other indications, such as botulinum toxin A and the antiepileptic oxcarbazepine, which have recently found to be effective in peripheral neuropathic pain. Emerging nondrug medical therapy with promising results in neuropathic pain also encompasses noninvasive brain neurostimulation techniques, such as repetitive transcranial magnetic stimulation and transcranial direct electrical stimulation. In this article, we review emerging medical treatments for neuropathic pain that are clinically available or with promising results from clinical trials.