Assessing and Treating Patients With Neuropathic Pain

Scholten, Paul; Harden, R. Norman

doi:10.1016/j.pmrj.2015.08.014

Cited by 10 publications

(2 citation statements)

References 130 publications

(170 reference statements)

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“…Chronic neuropathic and inflammatory pain have been estimated to affect one-sixth of the population and impair their quality of life. , Neuropathic pain is a devastating consequence of injury or disease that affects the somatosensory system, either centrally or peripherally . Chronic inflammation can lead to hypersensitization of neurons and the release of inflammatory mediators, such as bradykinins and prostaglandins, thereby promoting the process of inflammatory pain .…”

Section: Discussionmentioning

confidence: 99%

Novel Cyclic Endomorphin Analogues with Multiple Modifications and Oligoarginine Vector Exhibit Potent Antinociception with Reduced Opioid-like Side Effects

Zhang

Wang

et al. 2021

J. Med. Chem.

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Endomorphins (EMs) are potent pharmaceuticals for the treatment of pain. Herein, we investigated several novel EM analogues with multiple modifications and oligoarginine conjugation. Our results showed that analogues 1–6 behaved as potent μ-opioid agonists and enhanced stability and lipophilicity. Analogues 5 and 6 administered centrally and peripherally induced significant and prolonged antinociceptive effects in acute pain. Both analogues also produced long-acting antiallodynic effects against neuropathic and inflammatory pain. Furthermore, they showed a reduced acute antinociceptive tolerance. Analogue 6 decreased the extent of chronic antinociceptive tolerance, and analogue 5 exhibited no tolerance at the supraspinal level. Particularly, they displayed nontolerance-forming antinociception at the peripheral level. In addition, analogues 5 and 6 exhibited reduced or no opioid-like side effects on gastrointestinal transit, conditioned place preference (CPP), and motor impairment. The present investigation established that multiple modifications and oligoarginine-vector conjugation of EMs would be helpful in developing novel analgesics with fewer side effects.

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Section: Discussionmentioning

confidence: 99%

Novel Cyclic Endomorphin Analogues with Multiple Modifications and Oligoarginine Vector Exhibit Potent Antinociception with Reduced Opioid-like Side Effects

Zhang

Wang

et al. 2021

J. Med. Chem.

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“…[1][2][3] Few clinical guidelines for the treatment of sciatica exist, and evidence regarding effective medical treatments is limited. 2,3 Treatment with pregabalin (Lyrica, Pfizer) has been shown to be effective in reducing some types of neuropathic pain, including postherpetic neuralgia and diabetic peripheral neuropathy, 4,5 as well as allodynia and hyperalgesia from several conditions, [6][7][8] and some guidelines recommend pregabalin for the treatment of pain with neuropathic features. 5 Pregabalin therefore represents a potential treatment for sciatica.…”

mentioning

confidence: 99%

Trial of Pregabalin for Acute and Chronic Sciatica

Figueiredo

Teixeira

2017

N Engl J Med

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BACKGROUND Sciatica can be disabling, and evidence regarding medical treatments is limited. Pregabalin is effective in the treatment of some types of neuropathic pain. This study examined whether pregabalin may reduce the intensity of sciatica. METHODS We conducted a randomized, double-blind, placebo-controlled trial of pregabalin in patients with sciatica. Patients were randomly assigned to receive either pregabalin at a dose of 150 mg per day that was adjusted to a maximum dose of 600 mg per day or matching placebo for up to 8 weeks. The primary outcome was the leg-pain intensity score on a 10-point scale (with 0 indicating no pain and 10 the worst possible pain) at week 8; the leg-pain intensity score was also evaluated at week 52, a secondary time point for the primary outcome. Secondary outcomes included the extent of disability, back-pain intensity, and quality-of-life measures at prespecified time points over the course of 1 year. RESULTS A total of 209 patients underwent randomization, of whom 108 received pregabalin and 101 received placebo; after randomization, 2 patients in the pregabalin group were determined to be ineligible and were excluded from the analyses. At week 8, the mean unadjusted leg-pain intensity score was 3.7 in the pregabalin group and 3.1 in the placebo group (adjusted mean difference, 0.5; 95% confidence interval [CI], −0.2 to 1.2; P = 0.19). At week 52, the mean unadjusted leg-pain intensity score was 3.4 in the pregabalin group and 3.0 in the placebo group (adjusted mean difference, 0.3; 95% CI, −0.5 to 1.0; P = 0.46). No significant between-group differences were observed with respect to any secondary outcome at either week 8 or week 52. A total of 227 adverse events were reported in the pregabalin group and 124 in the placebo group. Dizziness was more common in the pregabalin group than in the placebo group. CONCLUSIONS Treatment with pregabalin did not significantly reduce the intensity of leg pain associated with sciatica and did not significantly improve other outcomes, as compared with placebo, over the course of 8 weeks. The incidence of adverse events was significantly higher in the pregabalin group than in the placebo group.

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Stroke: A Complication of Stellate Ganglion Block

Nelson

2017

Challenging Cases and Complication Management in Pain Medicine

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Assessing and Treating Patients With Neuropathic Pain

Cited by 10 publications

References 130 publications

Novel Cyclic Endomorphin Analogues with Multiple Modifications and Oligoarginine Vector Exhibit Potent Antinociception with Reduced Opioid-like Side Effects

Novel Cyclic Endomorphin Analogues with Multiple Modifications and Oligoarginine Vector Exhibit Potent Antinociception with Reduced Opioid-like Side Effects

Trial of Pregabalin for Acute and Chronic Sciatica

Stroke: A Complication of Stellate Ganglion Block

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