PainRelief.com Interview with:
Chief Executive Officer of Ethos Laboratories
How can reducing healthcare costs be achieved by the identification and validation of biomarkers through diagnosis and treatment of chronic pain?
Response: Medicine has been evolving over the past couple of decades with a shift to personalized or targeted medicine. As technology has improved and equipment capabilities have increased, the ability to identify and measure biomarkers is more affordable and accessible than ever before. Physicians now have access to more information specific to each individual patient, and as a result, can personalize treatment for each patient.
Chronic pain is a very difficult disease for physicians to treat. The majority of assessments used by the physician are subjective in nature and rely heavily on accurate information provided by the patient, which can lead to unnecessary treatments. By adding an objective measurement as part of the chronic pain assessment, unnecessary treatments can be avoided and targeted treatments can be pursued. By reducing the number of unnecessary treatments, not only does the cost of care for the patient go down, but the quality of the care is improved.
Using objective biomarkers as part of the chronic pain assessment will also provide some information on the viability of prescribing opioids at that time. Opioids will not help improve a patient’s biochemistry, and in some cases, opioids can have a negative effect on biochemistry. By treating abnormal biochemistry with safe inexpensive options first, it may be possible to avoid long term opioid prescribing for some patients, which would eliminate the costs associated with opioids in that patient subset.
PainRelief.com: What are the biomarkers of inflammation, oxidative stress and micronutrient deficiencies Ethos has identified?
Response: Ethos has developed highly sensitive and specific laboratory methods to quantify and evaluate well characterized biomarkers of inflammation, oxidative stress, and micronutrient deficiencies. Individual markers in this innovative panel have been explored and used clinically for many years but novel research conducted by Ethos confirms that these biomarkers are intimately linked to the development and/or deterioration of chronic pain. Inflammation status is assessed by quantitative characterization of kynurenine pathway metabolites such as quinolinic acid and kynurenic acid. Oxidative stress markers evaluate glutathione, coenzyme Q10 and carnitine status while micronutrient markers are able to detect common deficiencies which drive neuropathic pain.
PainRelief.com: How can alleviating pain potentially lessen the opioid burden?
Response: On the surface, it’s simple: less pain means less opioids which means less burden. I think the question is a little more complex than that and so is the answer. Opioids are the gold standard for pain management and have shown to be very effective in pain control. That holds true for acute pain, but when talking about chronic pain, there have been studies that show diminishing returns. A reasonable goal here would be to try reducing the number of patients that cross the threshold of acute pain to chronic pain. The more effective we become at accomplishing that goal the bigger impact we will have on reducing the opioid burden. By incorporating biomarker testing early and treating the patient’s biochemistry early, there is an opportunity to reduce the number of chronic pain patients which could lead to a reduction in the opioid burden.
PainRelief.com: What other services such as the Advanced Adherence Assessment and Pain Biomarker Assessment does Ethos provide?
Response: Ethos is now fully integrated with telehealth. Ethos telehealth program allows providers to order lab testing remotely for their patient population. The collection kits are sent directly to the patient’s house. The samples are then picked up from the patient’s home and lab results are ready for the providers to review 15 minutes after being released. The Advanced Adherence Assessment is available in addition to the Ethos Pain Biomarker Assessment and 100% of the current test menu is available through telehealth. Patients are encouraged to stay safe and stay home with at home collections.
Gunn J, Hill MM, Cotten BM, Deer TR. An Analysis of Biomarkers in Patients with Chronic Pain. Pain Physician. 2020;23(1):E41–E49.
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