Individualized Pharmacological Treatment of Neuropathic Pain

Helfert, S.; Reimer, Maren; Höper, Johanna; Baron, Ralf

doi:10.1002/cpt.19

Cited by 40 publications

(18 citation statements)

References 80 publications

(85 reference statements)

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“…[1][2][3][4] Although many pharmacotherapies (eg, gabapentin, pregabalin, and duloxetine) are effective in managing pain, drugs have adverse effects. 5,6 Therapeutic ultrasound (TU), a noninvasive method, is used in the treatment of carpal tunnel syndrome (CTS), the most common entrapment neuropathy. 7,8 There is a growing body of evidence that TU treats neuropathic pain.…”

Section: Resultsmentioning

confidence: 99%

“…38,39 Also, the noninvasive TU was often used in treating CTS, one of the most frequently compressive neuropathy. 5,6 However, it is unclear whether TU could treat persistent postoperative pain evoked by thoracotomy with rib retraction and the role of TU in its improvement. We showed that TU (1.0 W/cm 2 ) did reduce the persistent neuropathic pain, but the benefit was observed early and did not return to those of sham-operated animals.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Local Application of Ultrasound Attenuates Neuropathic Allodynia and Proinflammatory Cytokines in Rats After Thoracotomy

Hung

Chiu

Liu

et al. 2017

Regional Anesthesia and Pain Medicine

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Local Application of Ultrasound Attenuates Neuropathic Allodynia and Proinflammatory Cytokines in Rats After Thoracotomy

Hung

Chiu

Liu

et al. 2017

Regional Anesthesia and Pain Medicine

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“…‘Omics’ and other emerging biomarker data combined with computational tools for exploring large datasets suggest how much more patient information can be utilized to deliver more customized care in general [14] and in neuropathic pain in particular [15]. Ongoing efforts strive to identify psychosocial variables that could be used to identify patient subgroups [16] as well, even if the end goal of fully personalized or precision medicine cannot be achieved in the short term [5].…”

Section: Introductionmentioning

confidence: 99%

Integrating data from randomized controlled trials and observational studies to predict the response to pregabalin in patients with painful diabetic peripheral neuropathy

Alexander¹,

Edwards²,

Savoldelli³

et al. 2017

BMC Med Res Methodol

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BackgroundMore patient-specific medical care is expected as more is learned about variations in patient responses to medical treatments. Analytical tools enable insights by linking treatment responses from different types of studies, such as randomized controlled trials (RCTs) and observational studies. Given the importance of evidence from both types of studies, our goal was to integrate these types of data into a single predictive platform to help predict response to pregabalin in individual patients with painful diabetic peripheral neuropathy (pDPN).MethodsWe utilized three pivotal RCTs of pregabalin (398 North American patients) and the largest observational study of pregabalin (3159 German patients). We implemented a hierarchical cluster analysis to identify patient clusters in the Observational Study to which RCT patients could be matched using the coarsened exact matching (CEM) technique, thereby creating a matched dataset. We then developed autoregressive moving average models (ARMAXs) to estimate weekly pain scores for pregabalin-treated patients in each cluster in the matched dataset using the maximum likelihood method. Finally, we validated ARMAX models using Observational Study patients who had not matched with RCT patients, using t tests between observed and predicted pain scores.ResultsCluster analysis yielded six clusters (287–777 patients each) with the following clustering variables: gender, age, pDPN duration, body mass index, depression history, pregabalin monotherapy, prior gabapentin use, baseline pain score, and baseline sleep interference. CEM yielded 1528 unique patients in the matched dataset. The reduction in global imbalance scores for the clusters after adding the RCT patients (ranging from 6 to 63% depending on the cluster) demonstrated that the process reduced the bias of covariates in five of the six clusters. ARMAX models of pain score performed well (R 2: 0.85–0.91; root mean square errors: 0.53–0.57). t tests did not show differences between observed and predicted pain scores in the 1955 patients who had not matched with RCT patients.ConclusionThe combination of cluster analyses, CEM, and ARMAX modeling enabled strong predictive capabilities with respect to pain scores. Integrating RCT and Observational Study data using CEM enabled effective use of Observational Study data to predict patient responses.Electronic supplementary materialThe online version of this article (doi:10.1186/s12874-017-0389-2) contains supplementary material, which is available to authorized users.

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“…Clinically, sciatica and chronic back pain are the most common types of neuropathic pain, and the pathogenesis is complicated (2). The primary causes are the degeneration of the corresponding organs, lumbar disc herniation caused by trauma, nerve damage, calcification of ligaments, bone hyperplasia, inflammation and tumors (3)(4)(5). Due to the long period of clinical treatment, disease recurrence and poor prognosis, the quality of life of patients with neuropathic pain is greatly affected.…”

Section: Introductionmentioning

confidence: 99%

Role of miR-145 in chronic constriction injury in rats

Pang

Tang

Zhang

2016

Experimental and Therapeutic Medicine

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Abstract. The present study aims to investigate the effects and underlying mechanisms of miRNA-145 (miR-145) in rat models of chronic constriction injury (CCI). Rats were randomly divided into control, sham, CCI, agomiRNA (agomiR)-normal control (NC) and agomiR-145 groups (n=25 in each group); in addition, 30 rats with CCI were divided into small hairpin (sh)RNA-NC and shRNA-ras responsive element binding protein 1 (RREB1) groups. Paw withdrawal thermal latency (PWTL) and paw withdrawal mechanical threshold (PWMT) were detected. Reverse transcription-quantitative polymerase chain reaction was used to detect miR-145 expression levels, and western blotting was performed to measure RREB1 and phosphorylated-protein kinase B (p-AKT) expression levels. In addition, a dual luciferase reporter assay was conducted to identify the target gene of miR-145. PWMT and PWTL were decreased in CCI rats and this decrease was alleviated by miR-145 injection. At 1, 3, 5 and 7 days after CCI, miR-145 expression level in the spinal cord tissue of rats in the CCI group was significantly decreased compared with 1 day before CCI (P<0.05). Compared with the CCI group, miR-145 expression level in the agomiR-145 group was significantly higher (P<0.05). In addition, expression levels of RREB1 and p-AKT were significantly increased in the CCI group and significantly decreased in the agomiR-145 group (P<0.05). Furthermore, knockdown of RREB1 expression by shRNA-RREB1 significantly increased values of PWMT and PWTL, decreased expression levels of RREB1 and p-AKT, and increased miR-145 expression levels (P<0.05). Further investigation demonstrated that miR-145 can bind with RREB1 mRNA. In conclusion, miR-145 may be involved in the development of CCI through regulating the expression of RREB1.

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Individualized Pharmacological Treatment of Neuropathic Pain

Cited by 40 publications

References 80 publications

Local Application of Ultrasound Attenuates Neuropathic Allodynia and Proinflammatory Cytokines in Rats After Thoracotomy

Local Application of Ultrasound Attenuates Neuropathic Allodynia and Proinflammatory Cytokines in Rats After Thoracotomy

Integrating data from randomized controlled trials and observational studies to predict the response to pregabalin in patients with painful diabetic peripheral neuropathy

Role of miR-145 in chronic constriction injury in rats

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