Current challenges and future prospects in management of neuropathic pain.

Management of neuropathic pain is a challenge, as the currently available drugs usually do not target the multiple underlying mechanisms. This article will briefly review the currently available therapies for neuropathic pain as an introduction to those in clinical trials. The two most common conditions in clinical trials of neuropathic pain are diabetic neuropathy and postherpetic neuralgia. Central neuropathic pain remains a challenge in management. Future prospects of finding suitable drugs for neuropathic pain depend on an improved understanding of pain mechanisms. Biomarkers will facilitate the development of novel pain therapies. Molecular approaches to neuropathic pain include cell and gene therapies as well as RNAi-based treatments. Some of the novel targets for developing therapies for neuropathic pain include chemokine receptors, glial cells and cytokines. The review includes various suggestions for management of neuropathic pain, including multidisciplinary and personalized approaches. Considerable improvements are anticipated in the management of neuropathic pain in the next 5 years, although it is difficult to predict the chances of success of any particular product in development, considering the high rate of failures of previous trials.