Releviate Therapeutics focuses on treating pain at its source by removing specific matrix metalloproteinases (MMP-14 and MMP-9) that cause neuropathic and, possibly, nociceptive pain. Releviate offers a potentially first-in-class therapy that treats pain at its source, unlike opioids and anti-depressants, that mask the pain.

Despite a variety of causes of neuropathic pain, there is one thing in common: the mechanism of such pain development.

Table I depicts the most current classification of pain.

NEUROPATHIC = nerve injury NOCICEPTIVE = tissue injury NOCIPLASTIC MIXED
PERIPHERAL CENTRAL SOMATIC VISCERAL
Peripheral neuropathy
(1-3%)
Central post-stroke pain
(8%)
Arthritis
(25-40% in people > 40 years)
Endometriosis (10% in women of reproductive age) Irritable bowel syndrome
(5-15%)
Headache (15% for migraine, 20-30% for tension-type)
Postherpetic neuralgia
(annual incidence 0.1-0.2%)
Spinal cord injury (30-50%) Myofascial pain (5%-10%) Interstitial cystitis3
(0.2-1% of women)
Fibromyalgia
(3-6%)
Cancer5 (lifetime prevalence 30-40%)
Chronic postsurgical pain
(2-10% after surgery)
Multiple sclerosis
(25%)
Connective tissue disorders (0.2-0.5%) Ulcers/ gastritis/ esophagitis (3-9%) Complex regional pain syndrome type I (0.006-0.05%, 3%-20% after orthopedic surgery) Low back pain6 (annual prevalence rate 20-40%)
Phantom limb pain
(30-60%)
Parkinson’s disease
(10%)
Burn pain2 (annual incidence of burns requiring hospitalization 0.01%) Cholecystitis/ appendicitis Temporomandibular disorder (5-12%) Neck pain7 (annual prevalence rate 20-40%)
Trigeminal neuralgia (0.01%) Seizure disorder (1-3%) Ischemic pain6
Radiculopathy/ spinal stenosis (3%-10%)
Nerve entrapment syndromes (e.g. carpal tunnel, thoracic outlet, meralgia paresthetica; 2-4%)

 

Table I. Pain Classification.

Pain can be classified into four categories: neuropathic, nociceptive, nociplastic, and mixed. Neuropathic pain is divided into peripheral neuropathic pain, such as phantom pains, and central pain, such as multiple sclerosis-related pain. Nociceptive pain can be categorized into somatic pain, such as arthritis — one of our follow-up indications — and visceral pain, such as gastric-related pain. Finally, nociplastic pain is related to irritable bowel syndrome, and mixed pain includes cancer or low-back pain.

Neuropathic pain was not clearly defined mechanistically until 2008. Between 2006 and 2012, scientists and clinicians — currently associated with Releviate and UC San Diego, Duke University, Sanford Burnham Institute, and UC Riverside — discovered the molecular mechanism of neuropathic pain.

Before 2000, neuropathic pain was considered more of a psychiatric disorder. It was referred to as “psychotic pain” by many physicians, largely due to the misunderstood nature of the pain.

1820-1860s
  • Pain can be minimized and/or relieved.

  • Diagnostic tests are developed for specific ailments; clinicians dismiss chronic pain as a sign of mental disease.

  • People reporting unexplained chronic pain not well understood, and they were often thought to be delusional or seeking drugs

  • Pain is identified as both a psychological and physiological problem.

  • Pain is more than simply a symptom of disease (mental or physical).

  • Pain is individualized and can be helped through a multi-modal, personalized plan; there is a need for research to determine best approaches.

  • Releviate team scientist discovers Mechanisms of Action of MMP-9 and MMP-2 in Pain.

  • The Opioid Crisis escalates

  • Releviate team scientist discovers Mechanism of Action of MMP-14 in Pain.

  • Releviate is granted licenses and develops a go-to-market plan.

Late Industrial EraSecond Industrial RevolutionEarly to Mid-Twentieth CenturyCirca 1960s Circa 1972 Information Era 2006-201220102015 2020

It wasn’t until 2008 that neuropathic pain was clearly defined by the International Association for the Study of Pain (IASP) as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory nervous system.”

Releviate is pursuing two indications in neuropathic pain: Small Fiber Neuropathy (SFN) and Diabetes-induced Neuropathic Pain (DNP).

Nociceptive pain is the direct result of an injury, such as trauma, disc compression, carpal tunnel, or a tumor. One of the indications actively pursued by Releviate is Hip Osteoarthritic (Hip OA).