Table 1.
Summary of analgesic drugs in development by therapeutic target (December 31, 2019)
| Therapeutic target | Phase 1 | Phase 2 | Phase 3 | NDA/BLA submitted | NDA/BLA approved | Recently discontinued |
|---|---|---|---|---|---|---|
| α2δ-1 | 1 | 1 | ||||
| 5-HT2 antagonist | 1 | |||||
| Alpha2 agonist | 1 | |||||
| AMPA glutamate | 1 | |||||
| COMBINATION products | 2 | 8 | 5 | 3 | 2 | |
| BIOLOGICS* | 15 | 23 | 13 | 2 | 8 | |
| Bisphosphonate | 2 | 1 | ||||
| Cannabinoid (CB1, CB2) | 3 | 2 | ||||
| Ion channel: calcium (CaV channel) | 1 | |||||
| Ion channel: sodium (NaV channel) | 2 | 1 | ||||
| Ion channel: potassium (KV channel) | 1 | |||||
| CCR2 cytokine antagonist | 1 | |||||
| CGRP antagonist | 2 | 1 | 2 | 3 | ||
| Corticosteroid | 4 | |||||
| Opioid: mu agonist | 3 | 5 | 3 | 7 | ||
| Opioid: kappa agonist | 1 | |||||
| Opioid: delta agonist | 1 | |||||
| Opioid: endomorphin | 1 | |||||
| Opioid: enkephalinase inhibitor | 1 | |||||
| Opioid: other (NOP, undisclosed) | 1 | 1 | ||||
| Opioid: prodrug | 2 | 2 | ||||
| GnRH antagonist | 1 | |||||
| Ergot alkaloid | 2 | |||||
| Imidazoline agonist (I2) | 1 | |||||
| JAK1, pan-JAK inhibitor | 1 | 1 | 1 | |||
| Local anesthetic | 2 | 2 | 1 | 1 | ||
| Neurostimulation | 2 | 1 | ||||
| NGF inhibitor | 2 | |||||
| NMDA antagonist | 2 | 1 | ||||
| NSAID (COX-1, COX-2) | 2 | 2 | 1 | 1 | ||
| PDE9 inhibitor | 1 | |||||
| Prostaglandin synthase inhibitor | ||||||
| Sigma channel blocker | 1 | |||||
| Soluble epoxide hydrolase (sEH) inhibitor | 1 | |||||
| Soluble guanylate cyclase (sGC) | 1 | |||||
| Somatostatin SSTR4 agonist | 1 | |||||
| Superoxide dismutase mimic | 1 | |||||
| Syk inhibitor | 1 | |||||
| Triptan | 1 | 1 | ||||
| TrkA inhibitor | 1 | 1 | 1 | |||
| TRPA1 antagonist | 1 | |||||
| TRPV1 agonist (capsaicin, resiniferatoxin) | 1 | 2 | 1 | |||
| Wnt inhibitor | 1 | |||||
| Other mechanisms of action | 6 | 9 | 3 | 2 | 4 | |
| Total | 43 | 72 | 47 | 12 | 8 | 27 |
*BIOLOGICS (unless otherwise included above) include the following: ammonia-oxidizing bacteria (AOB), anti-CCP vaccine (citrullinated peptide dendritic cell immunotherapy), dipeptide aspartyl-alanyl diketopiperazine (DA-DKP), autologous bone morphogenetic protein (BMP-7), autologous gene therapy targeting BCL11A protein, BCG vaccine, chondroitin-sulfate-ABC endolyase, IL-1 inhibitor, IL-6 inhibitor, IL-10 inhibitor, IL-23 inhibitor, innate defense regulator (IDR), innate repair receptor peptide (IRR), gene encoding type VII collagen (COL7), NF-kB decoy, PACAP-38 inhibitor, P-selectin inhibitor, PEGylated uric acid specific enzyme, plasmid gene therapy encoding hepatocyte growth factor (HGF), proteoglycan aggrecan mimetic, stem cells, transthyretin (TTR) protein, type VII gene replacement