Comparative safety review of current treatment options for chronic low back pain and unmet needs: a narrative review. Issue 9 (2nd September 2021)

• Record Type: Journal Article
• Authors: Jovanovic, Filip; Pirvulescu, Iulia; Knezevic, Emilija; Candido, Kenneth D.; Knezevic, Nebojsa Nick
• Is Part Of: Expert opinion on drug safety. Volume 20:Issue 9(2021)
• Page Start: 1005
• Page End: 1033
• Publication Date: 2021-09-02
• Subjects: Chronic low back pain -- safety -- adverse events -- corticosteroids -- antidepressants -- gabapentinoids -- nsaids -- muscle relaxants -- nerve growth factors -- topical agents; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2021.1921142
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Introduction : The healthcare expenditures in the United States are substantial for the management of refractory, chronic low back pain (CLBP). The objective of this review is to summarize and evaluate the safety profiles of different pharmacological treatment options used in the management of CLBP. Areas covered : The authors conducted a search of randomized controlled trials (RCTs) assessing the safety profiles of different pharmacological agents used in the management of CLBP. This narrative review covered corticosteroids, opioids, antidepressants, gabapentinoids, nonsteroidal anti-inflammatory drugs, muscle relaxants, anti-nerve growth factor antibodies and topical agents, as monotherapy or in combination. Expert opinion : The risk-benefit ratio of a particular treatment is a subject driving the ongoing development of pharmaceuticals. The most commonly reported AEs across all drug classes are of gastrointestinal nature, followed by neurological and skin-related. These AEs include nausea, dizziness, constipation, arthralgia, headache, dry mouth, pruritus, etc. The majority of the AEs reported are not life-threatening, although they may lower patients' quality of life, thus, affecting their compliance. One of the biggest limitations of our review stems from the paucity of safety assessments in published RCTs. Advances in our understanding of the neurobiology of pain will promote development of new therapeutic strategies.