Severe Pain

According to the WHO up to 80 % of the world's population has either no or insufficient access to treatment for moderate to severe pain. Chronic pain has a disease burden greater than that of diabetes, heart disease and cancer combined [1] and an estimated impact on the economy of $100 billion a year in the United States [1]. An estimated 70 - 105 million Americans and around 20% of adults in Europe suffer from severe chronic pain. 

Current Management

The clinical management of chronic pain can be challenging and remains elusive for a large number of people in the world with opioids as the drugs of choice for the relief of moderate to severe somatic, visceral and neuropathic pain. However, the use of opioids is hampered by side effects, which are experienced by at least 80% of patients; these include constipation, nausea, somnolence, itching, dizziness, and vomiting. In fact, these side/adverse effects as well as the potential for addiction are some of the drivers for the development of alternatives. In fact the addictive potenital of opiates poses a significant health problem with overdoses being now being the leading cause of death for Americans under 50. The increasing abuse of prescritpion pain killers has been linked to what has been called an 'opioid epidemic and public health crisis' by FDA Commissioner Dr. Scott Gottlieb.

Nanomerics' Alternative

The body has the innate ability to control even severe pain via the opioid receptor system [2]. The µ, ∂, and k opioid receptors predominantly act to inhibit the transmission of pain signals in the central nervous system (CNS) as well as in the periphery. The endogenous peptide ligands for these receptors are all able to induce effective analgesia [3].
However, in order to be effective the peptide needs to reach the brain/CNS.  This is prevented by two barriers: uptake of peptides after oral administration does not occur because of their degradation and lack of absorption/uptake in the gut.  If peptides were able to get into the blood stream (e.g. after an injection) they can not get into the brain because of the blood-brain-barrier. To date these barriers have made it impossible to use the bodies own analgesics to treat pain.

Nanomerics have demonstrated that NM127 can provide rapid pain relieve for prolonged periods of time:

NM127

NM127 is a fast acting nanoenabled pain therapeutic, which is based on an endogenous peptide delta opioid receptor agonist.  NM127 is indicated for the treatment of moderate to severe pain.  Non-parenteral NM127 is comparable to subcutaneous morphine in preclinical pain models and the product has an attractive side effect profile, which differentiates it from the current marketed mu opioid receptor agonists. NM127 is being developed for the treatment of neuropathic and break-through cancer pain,  conditions that are poorly served by current products.

[1] Lohman, Diederik, Rebecca Schleifer, and Joseph J Amon. 2010. “Access to Pain Treatment as a Human Right..” BMC Medicine 8 (1). BioMed Central: 8. doi:10.1186/1741-7015-8-8.

[2] Dreborg, Susanne, Görel Sundström, Tomas A Larsson, and Dan Larhammar. 2008. “Evolution of Vertebrate Opioid Receptors..” Proceedings of the National Academy of Sciences 105 (40). National Acad Sciences: 15487–92. doi:10.1073/pnas.0805590105.

[3] Corbett, Alistair D, Graeme Henderson, Alexander T McKnight, and Stewart J Paterson. 2009. “75 Years of Opioid Research: the Exciting but Vain Quest for the Holy Grail.” British Journal of Pharmacology 147 (S1): S153–62. doi:10.1038/sj.bjp.0706435.