In some ways, neuropathic pain seems an odd choice of focus for a small start-up. It comes in many forms and its mechanisms are poorly understood. Moreover, the size and strength of those with stakes in the pain market might be another reason for emerging companies to steer clear. Fortunately, they're not. The unmet need is huge: Only one in two patients actually get some relief from existing drugs, in part because their mechanisms of action are fairly generalized. There remains plenty to be done in identifying and understanding the precise mechanisms behind the various flavors of neuropathic pain. For those whocan figure out new approaches to pain or new uses in pain for failed or overlooked compounds -- the companies profiled in this issue are doing both -- there's a big reward at the end: Sales of neuropathic pain therapies in the seven major pharmaceutical markets reached nearly $5 billion in 2007.

In some ways, neuropathic pain seems an odd choice of focus for a small start-up. It comes in many forms and its mechanisms are poorly understood. Moreover, the size and strength of those with stakes in the pain market might be another reason for emerging companies to steer clear. Fortunately, they're not. The unmet need is huge: Only one in two patients actually get some relief from existing drugs, in part because their mechanisms of action are fairly generalized. There remains plenty to be done in identifying and understanding the precise mechanisms behind the various flavors of neuropathic pain. For those whocan figure out new approaches to pain or new uses in pain for failed or overlooked compounds -- the companies profiled in this issue are doing both -- there's a big reward at the end: Sales of neuropathic pain therapies in the seven major pharmaceutical markets reached nearly $5 billion in 2007.

The calamitous demise of Vioxx and Celebrex has reinforced the terrific challenges facing companies that hope to develop novel therapies for pain. PainCeptor Pharma Corp. hopes to bring relief for many of the industry's miseries and tackle currently untreated PNS-based pain syndromes by recalibrating the pain management equation to focus on its first term.