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Table 3 Therapies that may be useful in treating FD pain

From: Pathophysiology and medical treatment of pain in fibrous dysplasia of bone

CURRENT AND POTENTIAL THERAPIES FOR TREATMENT OF FIBROUS DYSPLASIA PAIN
DRUG CLASS TARGET ACTION POTENTIAL COMPLICATIONS
Current therapies    
Biphosphonates Osteoclasts Osteoclast apoptosis Inhibition of bone remodeling/
   Osteoclast activity suppression growth
Osteonecrosis
Opioids CNS neurons Stimulates opioid receptors Sedation
Dependence
Constipation
NSAIDS Prostaglandin synthesis Blockade of peripheral and central sensitization GI toxicity
Cardiotoxicity
Nephrotoxicity
Recently approved therapies/ ongoing clinical trials for treating other skeletal pain states
Denosumab (OPG) Blocks RANKL Blocks osteoclast activation Inhibition of bone remodeling/
(Amgen)    growth
Osteonecrosis
Tanezumab (anti-NGF)
(Pfizer)
NGF/TrkA pathway Blockade of peripheral sensitization
Blockade of nerve sprouting
Developing sensory and sympathetic nerve fibers
Potential therapies
NGF/TrkA inhibitors (Array, JNJ, Abbott) NGF/TrkA pathway Blockade of peripheral sensitization
Blockade of pH sensitive neurons
Developing sensory and sympathetic nerve fibers
TRPV1 antagonists (Pfizer, JNJ, Abbott, Merck, GSK, etc.) TRPV1 channel Blockade of pH sensitive neurons Hyperthermia (transient?)
CSFR1 inhibitors response (Plexxikon, Roche, JNJ) Inhibition of CSFR1 Reduction in osteoclasts, macrophages, etc. Decreased immune response to infection
Pregabalin (Pfizer) Calcium channel, α2, δ1 subunit Aberrant neuronal discharge Lethargy
Drowsiness