Merz Therapeutics Presents New Phase 2 PaiNT Data in Peripheral Neuropathic Pain at IASP 2026

Merz Therapeutics, a leading player in neurology-focused specialty pharma, today announced the presentation of new clinical and translational research in peripheral neuropathic pain (PNP) at the International Association for the Study of Pain (IASP) 2026 World Congress in Bangkok, Thailand, taking place from 26 to 30 October. The research spans new Phase 2 findings on incobotulinumtoxinA in postherpetic neuralgia (PHN) and post-surgical/post-traumatic neuropathic pain (PS/PTNP), as well as preclinical studies exploring potential biological mechanisms involved in effects of incobotulinumtoxinA on PNP models, highlighting Merz Therapeutics’ growing presence in neuropathic pain.

In the PHN population of the Phase 2 PaiNT trial, results over 20 weeks favored incobotulinumtoxinA versus placebo treatment. In an exploratory analysis of average daily pain (ADP) intensity, the greatest difference between treatment groups was observed at Week 6 (adjusted mean difference, −1.14 points; p=0.0488). More weeks with ≥30% and ≥50% pain reduction were observed in the incobotulinumtoxinA group than in the placebo group. ^1, However, the primary endpoint of the PaiNT trial, combining the outcome of the PHN and PS/PTNP population, did not significantly separate from placebo. In the PS/PTNP population, the heterogeneity of underlying diagnoses made the comparison with placebo inconclusive. ^1,4

Most treatment-emergent adverse events were mild or moderate; treatment-related events were uncommon, and no serious treatment-related adverse events occurred. Tolerability was rated as good or very good for 72.7% of patients receiving incobotulinumtoxinA and 74.6% receiving placebo.² In patients with PHN, incobotulinumtoxinA was also associated with stable emotional outcomes and improvements in pain-related interference with daily functioning.³

“Neuropathic pain is complex and often has a significant impact on patients’ daily lives,” said Stefan Albrecht, CSO, Merz Therapeutics.“The breadth of research we are presenting at IASP reflects our work to better understand both the clinical experience of patients and how incobotulinumtoxinA may act on biological pathways involved in neuropathic pain. Our broader research is helping us explore potential mechanisms and inform the next steps in our pain research program.”

Beyond PaiNT, Merz Therapeutics is presenting research exploring how botulinum neurotoxin type A (BoNT/A) may influence biological pathways involved in neuropathic pain. In human sensory-neuron models, BoNT/A reduced neuronal excitability, with findings pointing towards potential effects on sodium, calcium, and TRPV1 ion-channel pathways involved in neuropathic pain signaling.⁵ Complementary preclinical research demonstrated incobotulinumtoxinA effects on spinal glutamate levels and molecular targets associated with inflammation and pain signaling, providing further insights into potential mechanisms for future investigation.^6,7

About the PaiNT trial

PaiNT was a Phase 2 proof-of-concept trial in adults with postherpetic neuralgia (PHN) or post-surgical/post-traumatic neuropathic pain (PS/PTNP). Participants received a single subcutaneous treatment with incobotulinumtoxinA, at a dose of up to 300 units across up to 60 injection sites within the painful area, or placebo, and were followed for 20 weeks.^8,9

IncobotulinumtoxinA is not approved for the treatment of peripheral neuropathic pain. Its safety and efficacy for this investigational use have not been established.

About Merz Therapeutics

Merz Therapeutics GmbH is dedicated to delivering better outcomes for more patients. With science as its foundation and the patient experience as its focus, the company relentlessly pursues innovative treatments and partnerships to address unmet needs in movement disorders, neurodegenerative conditions, liver disease, and other health conditions that severely impact patients’ quality of life.

Merz Therapeutics is headquartered in Frankfurt am Main, Germany, and is active in more than 80 countries. Merz Therapeutics GmbH is part of the Merz Group, a privately held, family-owned company with more than 115-year legacy. With passion and purpose, Merz Therapeutics continues to advance care in specialty neurology in ways that benefit both patients and society.

Please visit www.merztherapeutics.com.

References

1. Attal N, Bicker I, Pulte I, et al. IncobotulinumtoxinA in postherpetic neuralgia: sustained pain improvement in the PaiNT Phase 2 study. Presented at: IASP 2026; 2026.
2. Attal N, Bicker I, Pulte I, et al. Understanding patient heterogeneity & placebo response in post-surgical/traumatic neuropathic pain: results from the PaiNT proof-of-concept Phase 2 trial. Presented at: IASP 2026; 2026.
3. Viel E, Bicker I, Pulte I, et al. Safety and tolerability of subcutaneous incobotulinumtoxinA in peripheral neuropathic pain: findings from the PaiNT trial. Presented at: IASP 2026; 2026
4. Baron R, Attal N, Bicker I, et al. Functional and psychosocial benefits of incobotulinumtoxinA in postherpetic neuralgia: patient-reported outcomes from the PaiNT trial. Presented at: IASP 2026; 2026.
5. Oscar Sánchez-Carranza et al, Oscar Sanchez-Carranza, Claudia Jatzke, Andreas Gravius, Jens Nagel Botulinum Neurotoxin Type A Modulates Ion Channel Function in Human Sensory Neurons IASP, Bangkok. 2026
6. Nagel, et al.Jens Nagel, Oscar Sanchez-Carranza, Andreas Gravius IncobotulinumtoxinA Attenuates Pathological Spinal Glutamatergic Overactivity in a Rat Model of Neuropathic PainIASP, Bangkok 2026
7. Paulina Nunez Badinez, Oscar Sanchez-Carranza, Andreas Gravius, Jens Nagel Effects of IncobotulinumtoxinA in a Rat Model for Peripheral Neuropathic Pain IASP, Bangkok 2026
8. Attal N, Bicker I, Pulte I, et al. Efficacy & Safety of IncobotulinumtoxinA in Patients with Postherpetic Neuralgia – Results from the PaiNT Proof-of-Concept Phase 2 Trial. Accepted for presentation at: European Academy of Neurology (EAN); June 27–30, 2026; Geneva, Switzerland.
9. Attal N, Bicker I, Pulte I, et al. Understanding Patient Diversity & Placebo Response in Post-Surgical/Traumatic Neuropathic Pain – Results from the PaiNT Proof-of-Concept Phase 2 Trial. Accepted for presentation at: European Academy of Neurology (EAN); June 27–30, 2026; Geneva, Switzerland.

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