PainRelief.com Interview with: Andrew F. Russo, Ph.D. Professor, Dept. Molecular Physiology and Biophysics University of Iowa Iowa City, IA 52242
Dr. Russo
PainRelief.com: What is the background for this study?
Response: The company Schedule 1 Therapeutics approached us with an interest in testing a combination of CBD:THC in migraine. We thought the topic had tremendous public interest so we teamed up with them and won grants from the Migraine Research Foundation and from the National Institute on Drug Abuse.
PainRelief.com Interview with: Douglas P. Beall, MD, FSIR Chief of Radiology Services Clinical Radiology of Oklahoma
Dr. Bealll
PainRelief.com: What is the background for this study?
Response: Degenerative disc disease (DDD) is the leading cause of chronic low back pain and one of the world’s most common medical conditions contributing to high medical and disability costs. Healthy spinal discs act aids spine movement and distributes force which allows for spine flexibility and even distribution of the load that is placed on the spine. Each has a firm outer layer and a soft, jelly-like core. With normal aging, discs tend to become dry, thin, cracked or torn, which can cause pain and abnormal motion.
Substances called hydrogels, with biochemical similarities to the intervertebral disc designed to augment both the core and outer layer, have been used for years to help repair degenerated discs. First-generation hydrogels are placed as a soft solid, through a surgical incision, but were not simple to place and had a tendency to migrate from where they were originally placed.
For a first-in-human trial, our team conducted a prospective, single-arm feasibility study to evaluate an experimental, injectable hydrogel for safety and performance in relieving chronic low back pain caused by DDD. We used a second-generation hydrogel (Hydrafil™) developed by ReGelTec, Inc.. Unlike earlier hydrogels, it can be temporarily modified into a liquid and injected rather than placed through a small incision. In 2020, this product received FDA’s breakthrough device designation, allowing expedited review based on promising early evidence.
We recruited 20 patients, aged 22 to 69, who each described their pain as four or higher on a zero to 10 scale. None had found more than mild relief from non-surgical management, which includes rest, analgesics, physical therapy, and back braces. Patients were sedated for the procedure, and the gel was heated to become a thick liquid. Guided by fluoroscopic imaging, an interventional radiologist used a 17-gauge needle to inject the gel directly into the affected disc(s). The gel filled in cracks and tears and adhered to the disc’s core and outer layer.
PainRelief.com Interview with: Kun Zhang PhD Senior Service Fellow and Health Scientist Opioid Overdose Prevention Health Systems Team Division of Unintentional Injury Prevention Centers for Disease Control and Prevention
Dr. Zhang
PainRelief.com: What is the background for this study? are the main findings?
Response: When taken together by patients, opioids and benzodiazepines can result in synergistic respiratory depression which elevates overdose risk; however, these two medications have been commonly co-prescribed in the U.S.
Since 2016 there has been efforts to address the concurrent use of these two drugs, for example the 2016 FDA Boxed Warning and the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.
Our study aimed at tracking and analyzing recent trends in concurrent use of these two medications using national level data.
PainRelief.com Interview with: Mwidimi Ndosi PhD MSc BSc PGCert (Clin Ed) FHEA RN Sarah Bennet and Beth Jones Associate Professor in Rheumatology Nursing University of the West of England, Bristol Honorary Researcher University Hospitals Bristol and Weston NHS Trust
Dr.Ndosi
PainRelief.com: What is the background for this study? What are the main findings?
Response:Patient education is seen as an essential part of managing long-term conditions like inflammatory arthritis. Chronic inflammatory arthritis includes rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. We define patient education as a planned interactive learning process designed to support and enable people to manage their life with a disease and optimise their health and wellbeing.[1]
There are variations across Europe in the way patient education is delivered to people with inflammatory arthritis. In 2015, an international group of professionals and patients with inflammatory arthritis developed evidence-based recommendations for patient education [1]. This initiative was supported by the European Alliance of Associations for Rheumatology (EULAR), an organisation representing people with arthritis, health professionals in rheumatology and scientific societies of rheumatology in Europe.
In this study, we wanted to find out whether the recommendations were acceptable to patients and healthcare professionals. We also needed to know what helped people to follow these recommendations and what were barriers to putting them into practice. We surveyed health professionals in 20 countries in Europe, and 3 in Asia (India, Hong Kong and Japan) [2]
PainRelief.com Interview with: Grace H. Lo, MD MSc Assistant Professor of Medicine at Baylor College of Medicine Chief of Rheumatology and Investigator at the Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center, Houston, TX.
Dr. Grace Hsiao-Wei Lo
PainRelief.com: What is the background for this study?
Response: To conduct this study, we used data from the Osteoarthritis Initiative, a research endeavor that has been funded by the NIH and pharma partners for many years.
Our study including people age 50 and older who have signs of osteoarthritis in their knees.
When we looked at those who did not have regular knee pain at the beginning of the study, those who walked for exercise were LESS likely to develop regular knee pain compared to those who do not walk.
PainRelief.com Interview with: Kao–PingChua, MD, PhD Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan Medical School Department of Health Management and Policy University of Michigan School of Public Health, Ann Arbor
PainRelief.com: What is the background for this study?
Response: Opioid prescriptions written by dentists and surgeons are almost always written for the immediate relief of acute pain after procedures. However, current federal and state laws allow these prescriptions to be dispensed well after the time that they are written. When this occurs, that could be a potential sign that the prescription was used in a time frame or for a reason other than intended by the prescriber, both of which are forms of prescription opioid misuse.
PainRelief.com Interview with: David (Dedi) Meiri PhD Principal Investigato Laboratory of Cancer Biology and Cannabinoid Research Technion Israel Institute of Technology
PainRelief.com: What is the background for this study?
Response: We encountered numerous cancer patients that asked us whether medical cannabis treatment can benefit their health, however, while there is a lot of anecdotal evidence regarding the effectiveness of medical cannabis for pain, not much was known regarding its effectiveness in particular for the treatment of cancer-related pain; and there were no validated clinical studies. This motivated us to conduct an organized and thorough study that can serve patients and government ministries alike.
This study, which was conducted by Dr. Joshua Aviram as part of his postdoctoral fellowship, is the first to assess the possible benefits of medical cannabis for cancer-related pain in oncology patients, gathering information from right before they started the treatment and with repeated follow-ups for an extended period of time. Over a span of six months, we investigated the effectiveness and safety of medical cannabis treatment based on sound real-world evidence.
PainRelief.com Interview with: Janni Leung, PhD National Health and Medical Research Council Emerging Leadership Fellow National Centre for Youth Substance Use Research (NCYSUR) The University of Queensland
PainRelief.com: What is the background for this study?
Response: It is important to know the prevalence and source of medical cannabis use because non-prescribed use may put individuals at risk.
PainRelief.com Interview with: Eric C. Schwenk MD Anesthesiology Sidney Kimmel Medical College Thomas Jefferson University Philadelphia, Pennsylvania
Dr. Schwent
PainRelief.com: What is the background for this study? What are the main findings?
Response: Patients with refractory chronic migraine (rCM) have typically failed all available medications and many times have nearly constant headache pain and in many cases disability. Aggressive treatment is indicated to provide relief and help break the cycle of pain.
Lidocaine infusions have been used for decades in various acute and chronic pain conditions, including complex regional pain syndrome and pain after surgery. At the Jefferson Headache Center lidocaine has been a mainstay of treatment for such patients for several decades but evidence supporting its benefits is scarce.
The main findings were that patients with rCM experienced acute relief at the end of the infusion and that some relief was sustained at 1 month, although the degree of pain relief faded over time. It was also well tolerated with nausea and vomiting occurring in 16.6% of patients and other side effects occurring less frequently.
PainRelief.com Interview with: Imanuel Lerman MD MSc Associate Professor Affiliate Electrical and Computer Engineering VA San Diego Healthcare System Center for Stress and Mental Health Center for Pain Medicine UC San Diego Health Qualcomm Institute California Institute for Telecommunications and Information Technology (Calit2)
Dr. Lerman
PainRelief.com: What is the background for this study? What are the main findings?
Response:Spinal Cord Stimulation (SCS) offers an implantable, non-pharmacologic treatment for patients with intractable chronic pain conditions. There is extensive clinical literature that offers support for efficacy in chronic pain treatment for both Low frequency and High frequency based spinal cord stimulation. While Low Frequency SCS has been heavily examined since its inception, High Frequency SCS paradigms have recently been clinically approved.
Emerging preclinical work also show sex may alter certain immunological pathways that contribute to chronic pain. But to date few report have identified interactions between sex and SCS. Therefore, we aimed to fill this knowledge gap through a single site (University of California San Diego), large (n=237) retrospective (2004–2020) analyses that compared SCS paradigm Low vs High Frequency SCS, efficacy (pain relief and opiate sparing effects) across sex.
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