PainRelief.com Interview with: Andrew W Bergen, PhD Senior Scientist Oregon Research Institute Eugene, OR 97403
Dr. Bergen
PainRelief.com: What is the
background for this study?
Response: The background to the study is examination of the incident frailty risks of two classes of prescription drugs commonly co-prescribed in response to pain and sleep indications.
The dataset consisted of N=7,201 non-frail, age 65+, community-living individuals from the Health and Retirement Study, a nationally representative longitudinal cohort interviewed every two years.
The drug exposure measures
are based on responses to the two questions: “Do you regularly take
prescription medications for any of the following common health problems:
For pain in your joints or muscles?” and “Do you regularly take prescription medications for any of the following common health problems: To help you sleep?”.
The outcome measure was the Burden Model of frailty using the conventional threshold of >0.2 for frailty.
PainRelief.com Interview with: Caitlin Murray, PhD Research Fellow Center for Child Health, Behavior and Development Seattle Children’s Research Institute
Dr. Murray
PainRelief.com: What is the
background for this study?
Response: We know that chronic pain is a significant problem among children and adolescents, and that cognitive-behavioral therapy (CBT) can be helpful. However, studies show that CBT doesn’t help every child or adolescent affected by chronic pain.
In this study, we explored what factors predicted adolescents’ response to internet-delivered CBT for chronic pain—that is, which factors made it more likely that adolescents would benefit from the CBT intervention. Our primary treatment outcome was pain-related disability, or the extent to which pain interfered with the adolescent’s daily activities.
We found that both adolescent age and parent emotional distress predicted treatment efficacy up to one year after treatment, such that adolescents who were younger and those whose parents expressed less distress were more likely to benefit from this form of cognitive-behavioral therapy.
Oscar Javier Pico-Espinosa | MD, MSc, PhD (c) Epidemiology Karolinska Institutet
PainRelief.com: What is the
background for this study?
Response: Persistent neck pain is a common condition and one of the main causes of sick leave worldwide. Patients often utilize non-pharmacological therapies such as massage or exercises. However, the evidence supporting the effectiveness of such treatments is either lacking or conflicting. With that in mind, we designed the Stockholm Neck (STONE) trial, where we compared deep tissue massage, strengthening and stretching exercises and a combination of those two (up to six sessions over six weeks), versus advice (up to three sessions of advice to stay active).
PainRelief.com Interview with: Leon Timmerman, PhD St Antonius Hospital, Department of Anesthesiology Intensive Care and Pain Medicine The Netherlands
Dr. Timmerman
PainRelief.com: What is the
background for this study? What are the
main findings?
Response: Chronic pain is commonly treated
with pain medication. However, the results of pharmacological treatment are
often poor. One of the reasons might be that half of the patients do not use
their medication as prescribed. Underuse as well as overuse are common and have
been described to result in reduced treatment effect, health care risks and
unnecessary treatment changes. The are many risks factors described for
non-adherent behavior.
The way people think about their pain medication have been shown to be related to
the way they use their medication. With this study, we confirmed this relation
with a prospective study. Baseline beliefs about pain medication, measured by
‘Pain Medication Attitudes Questionnaire’, were found to be related to
underuse of pain medication, the occurrence of side effects and patient
satisfaction after three months.
PainRelief.com Interview with: Alex Fauer, RN, OCN® Ph.D. Candidate University of Michigan School of Nursing
PainRelief.com: What are the main findings?
Response: Our primary finding of the paper is that the age-, sex-, and US region-adjusted percentage of adults who used a gabapentinoid increased from 2.34% to 5.60% from 2005 to 2015. The total number of gabapentinoid prescriptions filled among US adults diagnosed with cancer was approximately 1.19 million in 2005, but increased to 3.52 million in 2015.
We also found that adults aged 18-44 were the highest users of gabapentinoids.
PainRelief.com: What is the background for this study? Would you explain how VM202 is unique?
Response: Diabetic peripheral neuropathy is one of the most common complications of diabetes and many of DPN patients suffer from severe pain that affects their daily activities and life quality. Though there are medications, both Rx and OTC drugs, used to ameliorate pains from diabetic peripheral neuropathy, many of them fall short of analgesic efficacy or often lead to not so trivial side effects.
Engensis (VM202) is plasmid DNA therapy, non-viral gene therapy, which encodes hepatocyte growth factor (HGF) gene that is designed to simultaneously express two isoforms of HGF protein at high levels. HGF is known to have angiogenic and neurotrophic effects and, when expressed in the human body, induces formation of new micro vessels and nerve regeneration through remyelination and axon outgrowth, resulting in improvement in peripheral neuropathy condition. Engensis does not integrate into the human genome.
Historically, our research first focused on therapeutic angiogenesis of HGF with a proof of concept research in critical limb ischemia, an extreme form of peripheral artery disease. In the process, we realized that Engensis would also be effective for peripheral neuropathy, and a coffee chat with the current PI, Dr. Kessler of Northwestern University, led to an idea of using Engensis in neurological diseases.
Throughout Phase 1 through 3 clinical trials for DPN in the US, Engensis has been observed safe and well-tolerated in patients, and, during the Phase 3 study, received RMAT (regenerative medicine advanced therapy) designation from the FDA.
PainRelief.com Interview with: Dr.-Ing. Marcus Komann IT-Coordinator Jena University Hospital Jena, Germany
PainRelief.com: What is the
background for this study?
Response: A lot of non-pharmacological methods (like relaxation, cold packs, prayer and so on) for post-operative pain relief are used in today’s hospitals. There is also some literature out there on this topic. However, the literature mostly concerns single methods and very specific patient groups. Further, for most methods, the literature is not clear on the pain soothing effects.
We looked at a real-life registry to study the effects of a large number of such methods on a big sample of patients.
PainRelief.com Interview
with: Roberta Agabio, M.D.
Dpt. Biomedical Sciences
University of Cagliari
Cittadella Universitaria Monserrato
Monserrato (CA) – ITALY
PainRelief.com: What is the
background for this study?
Response: Pain is the leading cause for seeking medical care
worldwide, and opioids are the most frequently prescribed drugs for pain relief.
Differences and similarities between men and women in both effectiveness and
side effects to opioids used for pain relief have been described. In addition,
individuals may respond differently to these medications for other reasons for
example: the intensity of pain experienced, amount and type of administration
of opioids (e.g. fixed doses established by physicians or flexible doses
decided by patients), mental condition, age, body weight, and use of alcohol,
tobacco and/or cannabis.
However, the role of these factors in influencing sex differences and similarities in the response to opioids used for pain control has not been thoroughly investigated.
Professor, University of California, San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences San Diego Supercomputer Center
PainRelief.com: What is the
background for this study? What are the
main findings?
Response: The background for this study was concern about unknown side effects of tramadol that became a popular treatment for chronic pain. With our informatics approach and access to millions of the FDA reports we were in a position to look for those adverse effects and we found that hyperglycemia (low blood sugar) is one of those concerns. There have been a few small-scale studies and case reports of tramadol use associated with hypoglycemia and hospitalizations related to it. The dramatic increase in tramadol prescription rates, especially in light of tighter control over hydocodone/acetaminophen (went from schedule III to II), warranted a larger scale postmarketing study of FDA FAERS reports.
As we compared the hypoglycemia side effect between different opioids we found that only one other drug, methadone (used to treat drug abuse and addiction), has a comparable association with hypoglycemia.
PainRelief.com: What should readers take away from your report?
Response:
Patients using tramadol should should be aware of
hypoglycemia symptoms such as shakiness, dizziness, sweating, hunger,
irritability, moodiness, anxiety/nervousness, and headache, or, in severe cases,
blurred vision, seizures or loss of consiousness. The same applies to
methadone, also known as Dolophine.
PainRelief.com: What recommendations do you have for future research as
a result of this work?
Response:
It may be beneficial to perform controlled studies to
confirm and understand this association. Our study looked at other drugs with
the known pharmacology of tramadol (mu-opioid agonism, serotonin/norepinephrine
re-uptake inhibition, and NMDAR antagonism), but did not find an association
with hypoglycemia with a specific class. Would be interesting to learn
more about additional/other pharmacology of tramadol and methadone behind the
etiology of hypoglycemia.
PainRelief.com: Is there anything else you would like to add?
Response:
We think that studies of this nature are beneficial since
rare side effects often go unnoticed in clinical trials due to a limited number
of participants. Additionally, hypoglycemia effects may often be attributed to
other medications and medical conditions, while tramadol or methadone were
unlikely to cause suspicion.
Any disclosures?
Non of the authors have any financial or non-financial conflicts
of interest to disclose.
Citation:
Tigran Makunts, Andrew U, Rabia S. Atayee, Ruben Abagyan. Retrospective analysis reveals significant
association of hypoglycemia with tramadol and methadone in contrast to other
opioids. Scientific Reports, 2019; 9 (1) DOI: 10.1038/s41598-019-48955-y
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MedicalResearch.com: What is the
background for this study?
Response: The findings of this study are based on a systematic review of 25 randomized clinical trials evaluating surgical type interventions (open surgeries, arthroscopic, endoscopic, laparoscopic, heart catheterization, radiofrequency, laser, and other interventions) for chronic back and knee pain. In each study, researchers had also performed sham procedures on a control group where they replicated the invasive procedure by omitting the step believed to be therapeutically necessary. The purpose of this it to determine how much of the effects are due to the placebo response.
The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, endorese, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. None of the content on PainRelief.com is warranted by the editors or owners of PainRelief.com or Eminent Domains Inc.
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