Tapentadol potentiates descending pain inhibition in chronic pain patients with diabetic polyneuropathy

Niesters, Marieke; Proto, Paolo; Aarts, Leon; Sarton, Elise; Drewes, Asbjørn Mohr; Dahan, Albert

doi:10.1093/bja/aeu056

Cited by 176 publications

(183 citation statements)

References 41 publications

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“…This finding contrasts the results of several controlled randomized trials in which tapentadol was reported to significantly reduce spontaneous pain in different acute and chronic pain syndromes, including chronic low back pain with a neuropathic component and painful diabetic neuropathy [13,26,27] . Tapentadol (immediate release) in comparison to placebo was able to reduce laserevoked potential responses and spontaneous pain in healthy volunteers using the UVB and topical capsaicin model within a randomized trial [28] .…”

Section: Discussioncontrasting

confidence: 99%

“…The number of selected subjects was based on experience from similar previous trials, which indicated that a sample size of 24 subjects for each cohort (i.e., model) is sufficient to detect single dose opioid effects in human evoked pain models of thermal and mechanical hyperalgesia [13,14,21,22] . This resulted in a preplanned total of 48 subjects for the entire pilot trial.…”

Section: Study Population and Ethicsmentioning

confidence: 99%

“…Research indicates that noradrenergic inhibition may lead to increased and more selective efficacy in neuropathic pain. Clinical efficacy has been shown in several randomized controlled trials of acute pain [5][6][7][8] , including postoperative pain, acute low back pain, and chronic pain, e.g., in painful polyneuropathy, chronic low back pain with and without neuropathic components, and chronic osteoarthritis and cancer pain [9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the antihyperalgesic effect of tapentadol in two human evoked pain models – the TapCapMentho pilot trial

Förster

Helfert

Dierschke

et al. 2016

Expert Opinion on Pharmacotherapy

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The discrepancy between pain models using healthy volunteers and drug trials under real acute and chronic pain conditions in patients as well as methodological aspects may have contributed to this result. The impact of these findings questions the general use of pain models as predictors for early decision making during drug development. The study was registered in ClinicalTrials.gov (NCT01615510).

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Section: Discussioncontrasting

confidence: 99%

Section: Study Population and Ethicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the antihyperalgesic effect of tapentadol in two human evoked pain models – the TapCapMentho pilot trial

Förster

Helfert

Dierschke

et al. 2016

Expert Opinion on Pharmacotherapy

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“…Ketamine [76], tapentadol [77], opioid agonists [78], [79], and an opioid antagonist [78] have not shown any modulatory effect.…”

Section: Offset Analgesiamentioning

confidence: 86%

“…However, few patient studies have been performed. Three studies have shown impaired offset analgesia in patients: one in diabetic polyneuropathy [77], one in cerebellar infarction [82], and one in painful neuropathic pain [69]. So far, no studies have been performed in patients with chronic joint pain.…”

Section: Offset Analgesiamentioning

confidence: 99%

Altered Central Sensitization and Pain Modulation in the CNS in Chronic Joint Pain

Arendt‐Nielsen

Skou

Nielsen

et al. 2015

Curr Osteoporos Rep

135

124

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Musculoskeletal pain disorders are the second largest contributor to global disability underlining the significance of effective treatments. However, treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the underlying peripheral and central pain mechanisms are not fully understood, and safe and efficient analgesic drugs are not available. The pain associated with joint pain is highly individual, and features from radiological imaging have not demonstrated robust associations with the pain manifestations. In recent years, a variety of human quantitative pain assessment tools (quantitative sensory testing (QST)) have been developed providing new opportunities for profiling patients and reaching a greater understanding of the mechanisms involved in chronic joint pain. As joint pain is a complex interaction between many different pain mechanisms, available tools are important for patent profiling and providing the basic knowledge for development of new drugs and for developing pain management regimes.

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Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt-Nielsen

Morlion

Perrot

et al. 2017

European Journal of Pain

Self Cite

444

443

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Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Significance Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.

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Tapentadol potentiates descending pain inhibition in chronic pain patients with diabetic polyneuropathy

Abstract: The study was registered at trialregister.nl under number NTR2716.

Cited by 176 publications

References 41 publications

Evaluation of the antihyperalgesic effect of tapentadol in two human evoked pain models – the TapCapMentho pilot trial

Evaluation of the antihyperalgesic effect of tapentadol in two human evoked pain models – the TapCapMentho pilot trial

Altered Central Sensitization and Pain Modulation in the CNS in Chronic Joint Pain

Assessment and manifestation of central sensitisation across different chronic pain conditions

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