Table 3.

Therapies that may be useful in treating FD pain

CURRENT AND POTENTIAL THERAPIES FOR TREATMENT OF FIBROUS DYSPLASIA PAIN
DRUG CLASS	TARGET	ACTION	POTENTIAL COMPLICATIONS
Current therapies
Biphosphonates	Osteoclasts	Osteoclast apoptosis	Inhibition of bone remodeling/
		Osteoclast activity suppression	growth Osteonecrosis
Opioids	CNS neurons	Stimulates opioid receptors	Sedation Dependence Constipation
NSAIDS	Prostaglandin synthesis	Blockade of peripheral and central sensitization	GI toxicity Cardiotoxicity Nephrotoxicity
Recently approved therapies/ ongoing clinical trials for treating other skeletal pain states
Denosumab (OPG)	Blocks RANKL	Blocks osteoclast activation	Inhibition of bone remodeling/
(Amgen)			growth Osteonecrosis
Tanezumab (anti-NGF) (Pfizer)	NGF/TrkA pathway	Blockade of peripheral sensitization Blockade of nerve sprouting	Developing sensory and sympathetic nerve fibers
Potential therapies
NGF/TrkA inhibitors (Array, JNJ, Abbott)	NGF/TrkA pathway	Blockade of peripheral sensitization Blockade of pH sensitive neurons	Developing sensory and sympathetic nerve fibers
TRPV1 antagonists (Pfizer, JNJ, Abbott, Merck, GSK, etc.)	TRPV1 channel	Blockade of pH sensitive neurons	Hyperthermia (transient?)
CSFR1 inhibitors response (Plexxikon, Roche, JNJ)	Inhibition of CSFR1	Reduction in osteoclasts, macrophages, etc.	Decreased immune response to infection
Pregabalin (Pfizer)	Calcium channel, α2, δ1 subunit	Aberrant neuronal discharge	Lethargy Drowsiness