Novel approaches for drug development against chronic primary pain: A systematic review.
British journal of pharmacology November 14, 2025 Valéria Tékus, Éva Borbély, Andreas Goebel et al. 5 citations
A systematic review of Phase 1-3 clinical trials from 2014 to 2024 found no breakthrough in pharmacotherapy for chronic primary pain conditions including fibromyalgia, complex regional pain syndrome, and chronic low back pain. The lack of progress may stem from unsuccessful approaches to reveal pathophysiological mechanisms, lack of translational preclinical animal models, and patient population heterogeneity with comorbidities. Most trials focused on repurposing antidepressants, antiepileptics, psychedelics, and immune modulators. Promising candidates targeted cannabinoid, glutamate, GABAergic, neuroinflammatory, and immune mechanisms. Only cannabidiol (CBD) and (es)ketamine were tested for all three conditions despite similar etiological factors.