Progress in Analgesic Development: How to Assess its Real Merits?

Area of Science:

• Pharmacology
• Drug Discovery
• Pain Management

Background:

• Despite extensive research and numerous new analgesics introduced over 50 years, current pain treatments offer limited effectiveness, especially for chronic and neuropathic pain.
• The widespread use of mu-opioid receptor agonists has contributed to the global opioid crisis, highlighting the need for safer and more effective pain management strategies.
• Assessing the true merit of new analgesic drugs is complex, with initial introductions often perceived as successes before limitations become apparent.

Purpose of the Study:

• To introduce a multifactorial approach for evaluating new analgesic drugs.
• This approach integrates clinical trial data, molecular target novelty, commercial viability, and scientometric interest.
• The goal is to provide a more comprehensive assessment of analgesic drug candidates.

Main Methods:

• Application of a multifactorial assessment framework to analgesics developed between 1982 and 2016.
• Evaluation criteria included clinical trial outcomes, novelty of molecular targets, commercial appeal, and scientometric indices.
• Comparative analysis against existing treatments like opioids and nonsteroidal anti-inflammatory drugs (NSAIDs).

Main Results:

• New analgesic drugs, even those with novel mechanisms, consistently exhibit modest therapeutic advantages over existing treatments.
• Approved drugs and candidates show a narrow spectrum of efficacy across different pain types, failing to significantly displace opioids or NSAIDs.
• Despite advancements, persistent challenges remain in developing analgesics with broad-spectrum effectiveness and superior therapeutic profiles.

Conclusions:

• The multifactorial approach provides a more holistic evaluation of analgesic drugs, revealing both advantages and disadvantages.
• Current novel analgesics do not offer a substantial improvement in effectiveness or applicability compared to established pain medications.
• Further research is needed to develop analgesics that overcome the limitations of current treatments and address unmet needs in pain management.