The global pain therapeutics space is forecast to grow from $19.7 billion in 2016 to around $28.8 billion in 2023, representing a compound annual growth rate of 5.5%, according to business intelligence provider GBI Research.

The company’s latest report states that there are 817 products in the pain therapeutics pipeline, 63% of which are in the early drug development stages.

The first drugs belonging to this class are forecast for approval in 2018, including Teva’s Fremanezumab, Alder’s Eptinezumab, Amgen and Novartis’ Erenumab and Eli Lilly’s Galcanezumab.

Thomas Jarratt, Associate Analyst for GBI Research, explains: “A strong pipeline will be the key driver of market growth. Within the migraine segment, for example, product approvals will include a new class of drugs – calcitonin gene-related peptide receptor (CGRPR) antagonists.”

“Several drugs will also be approved for the alleviation of post-operative pain and for the treatment of chronic pain conditions such as osteoarthritis.”

It is likely that the introduction of CGRPR antagonists to the market will considerably change the treatment of migraine, as they demonstrate strong efficacy in migraine prevention via monthly injection, and also boast good safety profiles. GBI Research expects orally administered CGRPR antagonists to gain approval from 2020.

Jarratt continues: “Some products on the market are already used to prevent migraines, but this new drug class is the first attempt to specifically address migraine prevention, and has many advantages compared with drugs currently on the market. For example, several antidepressants and anticonvulsives, such as Lyrica, have been shown to decrease migraine frequency, but these are used off-label and are not FDA approved.

“Botox, by contrast, has strong efficacy for reduction in migraine days per month and is FDA approved, but is accompanied by side-effects including muscle stiffness, neck pain, partial facial paralysis and, paradoxically, migraine.”

“In addition, the use of Botox for migraine is restricted to chronic sufferers and is very expensive. In this way, the new class of drugs make a welcome change to the treatment paradigm.”