In November 2025, our CEO Steve Ruston participated in a fireside chat with FT US Pharmaceutical Correspondent Patrick Temple-West, discussing how the pharmaceutical industry is tackling chronic pain and the growing demand for non-addictive therapies, including the potential of one-off treatments like PP353 for chronic Low Back Pain associated with Modic changes.
I recently had the opportunity to speak at the FT Global Pharma and Biotech Summit, taking part in a fireside chat with Patrick Temple-West, the FT’s US Pharmaceuticals Correspondent. The strength of the FT conference lies in its ability to bring the right people together — especially those who might want to play a role in the future of PP353. In our discussion we explored the significant unmet need of the millions of patients suffering from chronic back pain and how Persica’s approach to addressing the underlying cause rather than the symptoms could be transformative for them.
A significant healthcare challenge
Chronic Low Back Pain (cLBP) is a debilitating and costly disease that affects millions of people worldwide. The direct and indirect cost of treating back pain is greater than the cost associated with most, if not all, other chronic conditions. It is a huge problem, and many of us will know someone who is affected by it.
The problem with current treatments
Despite the size of the problem, for many patients, there simply aren’t effective therapies available. We have rightly seen a growing demand for non-opioid, non-addictive pain relief. But the need for new treatments isn’t solely about opioid vs non-opioid. It’s about finding treatments that work and that provide lasting relief, with good efficacy and few side effects.
It’s important to understand the impact of chronic back pain. This is about disability, not just pain. For the patients affected, this can have a severe impact on their lives; they aren’t just seeking pain relief, they want to get back to a normal quality of life.
Current treatments focus on controlling the pain and not on addressing its underlying cause. At Persica we are developing a completely novel approach to back pain focussing on addressing the cause rather than the symptoms.
Developing a transformative, non-opioid treatment for patients
At Persica Pharmaceuticals, our Phase Ib clinical trial has shown that we can achieve significant reduction in pain and disability, sustained over 12 months. We have also seen a reduction in analgesic and opioid use.
We have taken a fundamentally different approach, focusing on the underlying cause of the problem rather than just the symptoms. Our drug in development, PP353 for patients with chronic Low Back Pain (cLBP) with Modic changes, is based on the discovery that bacterial infection in the spinal disc, akin to tooth decay, can drive chronic inflammation leading to back pain. PP353 is a non-opioid, one-off treatment (two injections four days apart) that targets the underlying bacterial infection. Unlike conventional approaches that manage symptoms, PP353 targets these “bugs in discs”, reducing inflammation, pain and disability at source.
Our aim was to develop a treatment with minimal side-effects that gets right to the heart of the problem. PP353 is a unique formulation of linezolid that efficiently targets the cause of pain and disability.
We hope to shift the mindset from “bad back” to “spinal infection” and potentially provide a new treatment option for patients.
Innovation in pain management and moving towards precision medicine
Historically, there haven’t been many new treatments for cLBP but innovative approaches are now emerging with a range of novel mechanisms, such as Basivertebral nerve ablation (BVNA) and stem cell therapy, and a clear goal is to develop non-opioid therapies to address this area of high unmet medical need.
Chronic Low Back Pain is one of the most common chronic diseases, and yet one of the hardest to treat, with many different underlying pathologies requiring different therapeutic approaches. So, we need a better understanding of the patient sub-populations and better ways to identify and treat them. We estimate that there are at least two million people in the United States in this group – and many more globally. By directly treating the cause of the problem and not the symptoms, we believe our approach will be highly effective as well as being simpler and more cost effective than other mechanisms.
Registrational trials for PP353
The strength of our Phase 1b data, announced earlier this year, has positioned us well for the next phase of development. We’re currently in discussions with regulators about registrational trials and are looking for partners to help advance our programme through Phase 3 and bring this potentially transformative treatment to patients as quickly as possible.
The human impact
It’s important to understand the misery of living with cLBP. We hear from patients and their families and carers about the toll that it can have on them. The prospect of being able to do something about this is incredibly compelling – and what drives our team forward every day. Patients in our trial have described the impact of successful treatment: being able to ride a bike again, taking their children to school, going to work, or even just being able to put socks on in the morning. That’s why we’re in this business – to make a positive impact, on a large scale, on patients’ lives.
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