Tag Archives: #pain

Gabapentin in Overdose Patients Not Necessarily the Cause of the Overdose

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MedicalResearch.com Interview with:
Matthew S. Ellis, PhD, MPE
Department of Psychiatry
School of Medicine
Washington University in St. Louis

Kevin Xu MD, MPH
Instructor in Psychiatry
Co-Director, PGY2 Substance Use Disorders Rotation
Department of Psychiatry
School of Medicine
Washington University in St. Louis

MedicalResearch.com: What is the background for this study?

Response: Gabapentin is one of the most commonly prescribed psychotropic medications, as it is used (primarily off-label) to treat a myriad of conditions, ranging from anxiety disorders and insomnia to chronic pain, seizure disorders, and substance use disorders.
This is even more true for individuals receiving treatment for opioid use disorder, who often have multiple physical and mental co-morbid conditions.

Unfortunately, it  has increasingly been found in people who overdose, causing physicians and policymakers to consider restricting access to gabapentin and tapering/deprescribing it in stable patients taking it in the long-term.

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Venous Embolism Risk Increased With Hormonal Contraceptions, Especially with NSAIDs for Pain Relief

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PainRelief.com Interview with:
Amani Meaidi, Postdoc, MD, Ph.D.
Danish Cancer Society
Danish Cancer Society Research Center
Copenhagen

PainRelief.com: What is the background for this study?

Response: Use of birth control formulations containing estrogen (combined hormonal contraception) is an acknowledged risk factor for venous thromboembolism.

NSAID use has also been shown to increase risk of thrombosis

NSAID use is likely to be the most common co-medication to hormonal contraception use – still, no study has looked at the effect of concomitant use of hormonal contraception and NSAID on venous thromboembolic risk.

Thus, we decided to study the thrombosis safety of using hormonal contraception and NSAIDs simultaneously. 

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Nerve Pathway Identified That May Mitigate Pain from Endometriosis

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PainRelief.com Interview with:
Robert N. Taylor, MD PhD
Professor of Obstetrics and Gynecology
Investigator, Clinical and Translational Research Center
Jacobs School of Medicine and Biomedical Sciences
University at Buffalo

PainRelief.com: What is the background for this study?

Response: Our laboratory has been interested in the hormonal modulation of endometriosis-associated pain for decades. This disease and its manifestations are multifactorial. In the current study we focused on the role of nerve growth factors and their receptors, interactive proteins that direct the growth of new nerves and allow their circuits to communicate to regions of the brain that sense pain.

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Cannabis Smoke Exposure is Not Risk Free

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PainRelief.com Interview with:
Beth Cohen, MD MAS
Professor of Medicine, UCSF
Co-Director, PRIME Internal Medicine Residency Program
Staff Physician, San Francisco VA Medical Center

PainRelief.com: What is the background for this study?

Response: Though rates of tobacco use are declining, rates of cannabis use are increasing as it becomes more widely legal and available. Though there is not as much research on the long-term health effects of cannabis, cannabis and tobacco smoke contain many of the same carcinogens and toxins and both have particulate matter than is harmful when inhaled.

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Medical Music Therapy: Another Tool in Pain Relief Treatment

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PainRelief.com Interview with:
Seneca Block, Ph.D(c), MT-BC  
The Lauren Rich Fine Endowed Director of Expressive Therapies
Adjunct Instructor, School of Medicine, Dept. of Psychiatry, CWRU
Director AMTA National Roster Internship
Board Certified Music Therapist
University Hospitals Connor Whole Health
Cleveland Medical Center
Cleveland Ohio 44106

PainRelief.com: What is the background for this study? What types of music do you utilize?

Response: We summarized a process improvement initiative aimed to increase a large scale medical music therapy group’s (13.3FTE) pre and post metrics collection of patient reported outcomes including stress, pain, anxiety and coping. Music Therapy sessions featured multiple interventions utilizing patient preferred music facilitated live by board certified music therapists. As a quality improvement initiative, a series of team training sessions were implemented to provide education on data capturing techniques of patient reported outcomes.

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Study Finds TENS Device, Usually Used for Pain Relief, May be Useful in Sleep Apnea

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PainRelief.com Interview with:
Joerg Steier PhD
Professor of Respiratory and Sleep Medicine
Guy’s & St. Thomas NHS Foundation Trust
King’s College London

PainRelief.com: What is the background for this study? Where is the TENS unit applied?

Response: Patients with obstructive sleep apnoea hold their breath at night, which fragments their sleep and leads to daytime symptoms like excessive daytime sleepiness. Keeping the tone of the neuromuscular structures, particularly the hypoglossal nerve and the genioglossus muscle, elevated at night using electrical current has become an established treatment over the last decade.

Hypoglossal nerve stimulation, however, is using an implantable device, is costly, and requires surgical intervention. The novelty in the current study is that using a transcutaneous electrical neurostimulator (TENS) that is placed underneath the chin in the submental area can achieve significant improvements sleep apnoea severity and associated symptoms as well.

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NEJM: Vertex Pharma Study Demonstrates Potential for First-in-Class Non-Opioid Treatment For Moderate to Severe Acute Pain

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PainRelief.com Interview with:
Vertex Pharma Company Spokesperson

PainRelief.com: What is the background for this study? How does VX-548 work?

Response: VX-548 is an oral, selective NaV1.8 inhibitor that is highly selective for NaV1.8 relative to other NaV channels. NaV1.8 is a voltage-gated sodium channel that plays a critical role in pain signaling in the peripheral nervous system. NaV1.8 is a genetically validated target for the treatment of pain, and Vertex has previously demonstrated clinical proof-of-concept with a small molecule investigational treatment targeting NaV1.8 in multiple pain indications including acute pain, neuropathic pain and musculoskeletal pain.

 Vertex’s approach is to selectively inhibit NaV1.8 using small molecules with the objective of creating a new class of medicines that have the potential to provide superior relief of pain without the limitations of opioids, including their addictive potential. VX-548 is the most advanced NaV1.8 inhibitor in Vertex’s program.

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NYU Lab Harnesses Gene Therapy to Tackle Chronic Pain

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PainRelief.com Interview with:
Rajesh Khanna, PhD

Director, NYU Pain Research Center
Professor, Department of Molecular Pathobiology
Professor, Department of Neuroscience and Physiology
Investigator, Neuroscience Institute
New York University


PainRelief.com: What is the background for this study?

Response: Chronic pain affects an estimated 20-30% of the global population, significantly impacting quality of life and mental health. It poses substantial socioeconomic burdens, with costs relating to healthcare and lost productivity. Despite its prevalence, chronic pain remains underdiagnosed and undertreated worldwide, highlighting a crucial need for enhanced awareness, research, and therapeutic strategies.

Among the many targets being pursued for the development of drugs against chronic pain conditions are key proteins in neurons that are involved in the signaling of pain. A key family of these targets is the voltage-gated sodium channel family. Among them, the Nav1.7 sodium channel plays a critical role in the development and maintenance of chronic pain. It is an integral part of the peripheral nervous system and is highly expressed in nociceptive (pain-sensing) neurons, including the dorsal root ganglia and sympathetic ganglion neurons.

Nav1.7 channels act as a threshold channel, amplifying small sub-threshold depolarizations and generating action potentials, which are the electrical signals responsible for transmitting sensory information, including pain, to the brain. In essence, they work as a key amplifier of signals from peripheral pain-sensing neurons to central pain pathways.

Certain genetic mutations that cause either a gain or loss of Nav1.7 function can lead to conditions associated with altered pain perception. Gain-of-function mutations, which increase the activity of the channel, can lead to pain syndromes like Inherited Erythromelalgia (IE) and Paroxysmal Extreme Pain Disorder (PEPD). In contrast, loss-of-function mutations, which decrease or eliminate the activity of Nav1.7, result in Congenital Insensitivity to Pain (CIP), a condition where individuals are unable to feel pain.

Given this integral role, Nav1.7 has become a focus of interest as a target for new analgesic drugs. The development of Nav1.7 inhibitors could offer a new avenue for more effective and targeted treatment strategies for chronic pain conditions. It’s a promising area of research, though there are still challenges to be met, such as achieving sufficient specificity for the Nav1.7 channel to avoid side effects associated with other sodium channels.

In the NYU Pain Research Center in the College of Dentistry at New York University (https://dental.nyu.edu/research/pain-research-center.html), the Khanna lab is pursuing alternative ways to target Nav1.7 for pain relief.

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State-Level Policies May Reduce Disparities in Pain Prevalence

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PainRelief.com Interview with:
Rui Huang MA
Department of Sociology
University at Buffalo
Buffalo, NY

PainRelief.com: What is the background for this study?

Response: In the U.S., approximately 58.5 million people (23.7% of adults) have arthritis, and at least 15 million of them suffer from severe arthritis-attributable joint pain. Severe joint pain is strongly associated with impaired functioning, disability, mortality, and limited life chances. People with less education disproportionately suffer from joint pain and reduced quality of life.

However, existing research on social determinants of pain relies primarily on individual-level data; it rarely examines the role of macro sociopolitical contexts, such as state-level policies.  Moreover, relatively little is known about the geographic distribution of pain, and even less is known about geographic variation in socioeconomic disparities in pain. 

To our knowledge, this is the first study to look at how U.S. state-level policies and characteristics shape risk of pain, and educational disparities in pain.

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Study Demonstrates Feasibility of Engineering Biomechanical Scaffolds for Cartilage Repair

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PainRelief.com Interview with:
Prof. Hongbin Li
Department of Chemistry
The University of British Columbia,
Vancouver, British Columbia, Canada

PainRelief.com: What is the background for this study?

Response: Cartilage degeneration and damage are significant health issues, and cartilage repair is a major challenge because cartilage has a limited capacity for self-repair. One of the strategies for cartilage regeneration is to use scaffolds to promote the growth and differentiation of chondrocytes. For this, the scaffolds need to be tough and stiff to meet the requirements of cartilage regeneration. However, it is challenging to engineer highly stiff and tough materials, as stiffness and toughness are often self-conflicting to each other. In this work, we developed a novel strategy to engineer stiff yet tough protein hydrogels whose mechanical properties mimic those of cartilage. Such engineered stiff and tough protein hydrogels were tested as implants to repair osteochondral defect in an animal model.

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