Chronic Lower Back Pain (CLBP) market size in 7MM is expected to grow at a CAGR of 4.84% for the study period (2017-2028). The CLBP therapy market although, is entirely dependent on supportive therapies, but the drugs such as opioids and NSAIDs, have also been approved to ease the pain associated with CLBP. The prescription of CLBP drugs varies greatly in 7MM. Use of opioids is more prevalent in the US, whereas the case is same with NSAIDs if we talk about EU5.
The chronic lower back pain aetiology, in 80-90% of cases, is a mechanical misbalance in the body, including a degenerative disc or joint disease, vertebral fracture, and deformities, and remaining of chronic lower back pain cases are due to neurogenic, or inflammatory. The CLBP treatment plan is primarily patient-specific. However, as the pain progresses to a chronic state (≥3months), a broader approach typically must be taken due to decreased efficacy of the targeted treatment. There exist several medication options which help in CLBP management. Especially for neuropathic pain, the medications recommended as first-line treatments include TCAs, SNRIs, calcium channel α2-δ ligands, and lidocaine patch. Opioid analgesics and tramadol are recommended as second-line CLBP treatments that can be considered for first-line use in selected clinical circumstances.
With the launch of the effective branded targeted therapies, the chronic lower back pain market is going to rise, adding another USD 623.19 million by 2022. Of the emerging therapies, Braeburn Pharmaceuticals/Camurus, Pfizer/Eli Lilly and Company, Mesoblast, Nektar Therapeutics, Egalet Corporation are expected to dominate the chronic lower back pain treatment market during the forecast period of 2019-2028. However, DelveInsight estimates that the current chronic lower back pain opioid prescription market is expected to decline in the coming years. The decline may be attributed to the anticipated shift of CLBP patients from currently prescribed opioids to emerging opioid therapies. NKTR-181 (Nektar Therapeutics), Buprenorphine (CAM2038; Braeburn Pharmaceuticals/Camurus), and Egalet-002 (Egalet Corporation) are some of the opioid therapies, which have proven safety and efficacy in CLBP patients. Other companies like Regeneron Pharmaceuticals, Teva, Astellas Pharma, Grünenthal GmbH, Frontier Biotechnologies, Semnur Pharmaceuticals, Sollis Therapeutics, and many others have shifted their focus towards advancing chronic lower back pain pipeline. While some of these are in the early stage of development, others have reached the NDA filling stage of development.
A thorough understanding of pain mechanisms and good communication between physicians and patients are required to improve patient outcomes. Avoiding ineffective treatments and maximising the CLBP treatments that have been proven beneficial in clinical trials (i.e., evidence-based treatments) are likely to produce better chronic lower back pain landscape. Additionally, identifying and co-managing pain that is comorbid with psychiatric disorders have promise for improving both the physical and psychological outcomes. Furthermore, the CLBP multimodality treatment approach is going to promise patients a painless life.