Basic Science Approach
Our Research into
Niche Pain Conditions
Bisphosphonates Case Study
Complex regional pain syndrome (CRPS): an orphan disease associated with chronic, extreme, debilitating pain
Neridronate is an amino-bisphosphonate with structural similarities to alendronate and pamidronate. Its use in CRPS is based on the broad effects of bisphosphonates and the multiple targets involved in the complex disease.
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Basic Science Approach: Targeting a Complex Syndrome
CRPS is, as its name suggests, a complex condition and a deep understanding of its pathophysiology is needed in developing a treatment. CRPS generally occurs as a severe overreaction to soft-tissue or bone injury (type I) or nerve injury (type II). Sensory, psychological, motor, inflammatory, and autonomic abnormalities typically manifest, with X-ray findings demonstrating a considerable impact on bones, including patchy osteoporosis.
We have utilised our understanding of CRPS in our research of neridronate. We have conducted pre-clinical and clinical proof-on concept trials which have shown promise for neridronate in inhibiting pain, bone loss and inflammation associated with CRPS.
Bisphosphonates are well-established in osteology, and are the standard care for the reduction of skeletal events associated with bone metastases. Neridronate is believed to act on several targets, including regional osteoporosis and bony nerve fibre compression of the cone, and visceral/motor spinal reflexes of the central nervous system.
Patient Perspective: Understanding CRPS
CRPS is a rare condition, affecting fewer than five people per 10,000 population, meaning that disease awareness and research is often lacking.
We have worked in partnership with patients and physicians to improve understanding of some of the key challenges in the CRPS patient journey including:
- Lack of awareness leading to delayed diagnosis and poor patient outcomes
- The difficult and debilitating disease progression and levels of personal loss that many patients experience
- High rates of untreated CRPS and low satisfaction rates with current treatment options for those with access to medical therapy
Intravenously administered neridronate is currently being investigated in a phase II clinical trial for the treatment of CRPS.
Our neridronate team is dedicated to patient-centred research into niche pain conditions:
- Clinical Lead: Bernd Lange
- Project Lead: Katrin Fleischer
- Translational Lead: Achim Kless