AntiNGF

AntiNGF refers to therapies that neutralize nerve growth factor (NGF), a neurotrophin involved in the development of neurons and in amplifying pain signals in adults. By binding NGF, these agents prevent activation of its receptors, primarily TrkA and p75, on sensory neurons. This reduces peripheral sensitization and can lower pain intensity in various chronic conditions. Anti-NGF strategies are mainly pursued with monoclonal antibodies that sequester NGF in the circulation and tissues.

Clinical development has focused on chronic pain conditions such as osteoarthritis of the knee and hip, chronic low back pain, and certain high-impact musculoskeletal disorders. In trials, anti-NGF antibodies have shown substantial pain relief and functional improvements in some patients who did not respond adequately to standard therapies. However, the magnitude and durability of benefit, and which patients are most likely to respond, vary across studies.

Safety concerns have been a major factor shaping the trajectory of anti-NGF programs. Notably, several late-stage trials reported accelerated joint damage and rapid progression of OA in a subset of participants, sometimes requiring joint replacement. These safety signals led to temporary suspensions and intensified scrutiny by regulatory authorities. Other risks under investigation include potential effects on mood or other sensory processes, and interactions with NSAIDs may influence risk profiles.

As of now, there are no anti-NGF therapies approved for widespread use in major markets. Research continues to refine dosing, patient selection, and monitoring strategies to balance analgesic benefit against joint safety risks, with some programs continuing in specialized indications or in combination with other therapies.