There is some good news on the horizon for millions of people worldwide battling severe back pain as a new drug on the anvil can be a real ‘gamechanger’ for them. The drug promising immense relief tackles the condition by using antibiotics rather than painkillers.
The drug is different from other back pain treatments because it targets the underlying cause of the problem rather than just its main symptom—pain.

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Doctors involved in the testing of the drug say that an infection rather than a muscular or spinal problem is the root cause of lower back pain in one of every four people, and the drug could be ‘a gamechanger’ for them, reports The Guardian.

Dr Shiva Tripathi, an NHS pain consultant and the chief investigator of the trial, said, “If the drug is approved by regulators and becomes available, it would be a gamechanger for chronic lower back pain on the similar levels as [how] antibiotics made a difference to infection. Because if we can get these 25% of the patients with chronic low back pain back to work, back to no medications, back to no more disability, then I think [that] will be the massive gamechanger for the future.”

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Early trials of the drug have revealed that six in 10 of those who took it reported major relief, including a substantial drop in the pain and disability they had been suffering all along.
Persica Pharmaceuticals, a Kent-based biotech firm, developing the drug, called PP353, conducted the trials in conjunction with six NHS hospitals in England and Wales.
The randomised controlled trial, however, involved just 44 patients—22 in Britain and 22 in Spain, Denmark, and New Zealand—and so PP353 needs to undergo further trials and will have to be endorsed by the medicines watchdogs, before doctors can prescribe it to lower back pain patients.

All the patients part of the trial had severe back pain for at least six months, and in some cases more than five years, and had not benefitted from the conventional treatment, such as painkilling medication.
The biotech firm says that a big advantage of the drug is that a patient has to take two injections four days apart rather than undergoing surgery or taking tablets for a long time. Recent studies have found that out of the 56 ways in vogue for alleviating back pain—ranging from massage and acupuncture to painkillers and physiotherapy—brought scant or no relief.

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PP353 is a combination of three substances that are already widely used in medicine: linezolid, an antibiotic; iohexol, a contrast agent or dye; and a thermosensitive gel. It is injected into the lower back in order to banish an infection that has developed around the discs.
Steve Ruston, the firm’s chief executive, said, “Our first patient trial produced really positive results. [It produced] significant reductions in pain and disability, and [patients also got] clinically meaningful benefit and statistically significant benefit. The patient benefit potential is enormous.”
“If you can reduce the pain and disability that people are living with in the way that some of our [trial] patients have responded, it will transform their lives,” Ruston added.

Market research shows that the drug could benefit 2 million people in the US and 250,000-300,000 in the UK. 
Many patients in the trial sensed a decline in pain within a month of the injections and were feeling a lot better after a year. However, they still needed to keep taking painkillers, though in much reduced quantity.

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Dr Benjamin Ellis, a consultant rheumatologist at Imperial Healthcare NHS Trust in London, who specialises in chronic pain, voiced scepticism about PP353’s potential.
“People with chronic low back pain are understandably desperate for anything that can help. There’s also a huge industry in supplying technologies and medicines that claim to help, but there’s little evidence that these do.”
“That being said, if there is a subgroup of people with chronic low back pain that can reliably and safely benefit from a simple pair of injections, then that would be fantastic news—but it seems unlikely.”