Interventions for treating neuropathic pain in people with sickle cell disease

Asnani, Monika; Brandow, Amanda M.; Gabbadon, Christine EO Hammond; Ali, Amza

doi:10.1002/14651858.cd012943.pub2

Cited by 6 publications

(7 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Examples of medications that have strong supporting evidence as first-line treatment of neuropathic and other pain include tricyclic antidepressants, serotonin noradrenaline reuptake inhibitors, selective serotonin reuptake inhibitors, and gabapentinoids such as gabapentin and pregabalin. 26 A recent systematic review by Asnani et al 27 found that just 1 randomized neuropathic drug clinical trial has been conducted in patients with SCD with only 22 subjects. 28 More trials are needed to support the efficacy of neuropathic medication in treating chronic pain in SCD.…”

Section: Neuropathic Painmentioning

confidence: 99%

Optimizing the management of chronic pain in sickle cell disease

2020

View full text Add to dashboard Cite

Chronic pain in sickle cell disease (SCD) refers to pain present on most days lasting over six months. It can start during childhood and the prevalence increases with age. By adulthood, over 55% of patients experience pain on over 50% of days; 29% reporting pain on 95% of days. The true prevalence of chronic pain in SCD is likely underappreciated as it is mostly managed at home. Patients with chronic pain and SCD frequently seek acute care for exacerbation of underlying chronic pain difficult to distinguish from their usual acute vaso-occlusive crises. When treating chronic pain in SCD, the challenge is distinguishing between non-SCD related etiologies versus chronic pain resulting from SCD pathophysiological processes. This distinction is important to delineate as it will drive appropriate management strategies. Chronic pain in SCD has profound consequences for the patient; is often associated with comorbid psychiatric illnesses (depression and anxiety), not dissimilar from other chronic pain syndromes. They may also experience challenges with sleep hygiene, various somatic symptoms, and chronic fatigue that impair quality of life. How best to treat chronic pain in SCD is not definitively established. Both acute and chronic pain in SCD is typically treated with opioids. Emerging data suggests that chronic opioid therapy (COT) is a suboptimal treatment strategy for chronic pain. This review will discuss the complexity of managing chronic pain in SCD; pain that may be dependent or independent of the underlying SCD diagnosis. We will also describe alternative treatment approaches to high-dose COT.

show abstract

Section: Neuropathic Painmentioning

confidence: 99%

Optimizing the management of chronic pain in sickle cell disease

2020

View full text Add to dashboard Cite

show abstract

“…As the model of pain in SCD grows more complex, so must the management approach. The rate at which patients receive medications targeting NP in particular as a cause of chronic pain lags far behind its likely prevalence among patients with SCD [ 4 , 5 , 39 ]. The recent guidelines from the American Society of Hematology for the treatment of SCD‐associated chronic pain include the use of several medications recommended for NP treatment in the broader pain literature, but the recommendations are based almost entirely on data from other disease processes due to the lack of clinical trials targeting NP in SCD [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Targeting TRPV1 activity via high‐dose capsaicin in patients with sickle cell disease

Glaros

Callaghan

Smith

et al. 2022

eJHaem

View full text Add to dashboard Cite

Evidence suggests neuropathic pain (NP) develops over time in sickle cell disease (SCD), contributing to a complex, difficult-to-treat phenotype, with management based on scant evidence. One characteristic of NP found is hyperalgesia caused by nervous system sensitization, but risk factors for this have not been identified within the SCD population, as exact mechanisms leading to its development are not well defined.The SPICE (Sickle cell Pain: Intervention with Capsaicin Exposure) trial was a pilot safety and feasibility trial of high-dose (8%) topical capsaicin for patients with SCD and recurrent/chronic pain with neuropathic features, aimed at exploring capsaicin's utility as a mechanistic probe and adjunctive pain treatment for this population. Ten participants identifying "target" sites of pain with NP-type qualities consented to treatment. The primary endpoint was safety/tolerability. The novel Localized Peripheral Hypersensitivity Relief score (LPHR) was developed to determine improvement in sensitivity attributable to TRPV1 neutralization. There were no severe treatment-related adverse events. Higher baseline pain sensitivity at a given body site was associated with self-reported history of more frequent localized vaso-occlusive pain episodes at that site. There was a statistically significant improvement in the mean LPHR, evidencing TRPV1's importance to the development of hypersensitivity and a potential therapeutic benefit of capsaicin for SCD.

show abstract

“…Waldfogel and collaborators (2017) found 10 studies of low quality of evidence involving pregabalin and quality of life, of which 4 show significant improvement, while 6 show no improvement compared to the placebo group according to the SF-36 (Waldfogel et al, 2017). In the review carried out by Asnani et al (2019) it was shown that the quality of life of patients using pregabalin did not improve compared to the placebo group according to the SF-36, however in three months of followup, a small improvement could be noted in 7 of 8 SF-36 domains post-intervention in the intervention group compared to the placebo group, all via the quality of evidence is very low (Asnani et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Quality of life in neuropathic pain: a literature review

Couto

Goulart

Luciano

et al. 2021

RSD

View full text Add to dashboard Cite

Introduction: Neuropathic pain may develop after injury to the central nervous system, peripheral or both, when deleterious changes occur along the nociceptive modulatory pathways of the central nervous system. Proper management requires an interdisciplinary approach, as it can impact quality of life. Objectives: This review of the literature aims to assess the impact of pharmacological and non-pharmacological factors in the quality of life of patients with chronic neuropathic pain. Methodology: A systematized virtual search was carried out in PubMed®, collected articles between January 2010 and May 2020 using the terms “neuropathic pain”, “treatment”, “human” and “systematic review” using the filters of “systematic reviews ”E“ published in the last 10 years ”. All articles were formed by two independent reviewers and tabulated in a spreadsheet using Microsoft Excel® software. Results: Non-pharmacological interventions were addressed by most articles. Some articles addressed pharmacological interventions, with painful diabetic peripheral neuropathy being the main etiology. The most used quality of life measurement tools were: Medical Outcomes Study 36 (SF-36); EuroQol-5 Dimension (EQ-5D) and Beck Depression Inventory Score (BDI). Conclusion: The scarcity of high-quality studies that measure quality of life through validated tools is an obstacle to credible analysis of the impact of interventions on the life of chronic pain patients, however, in a preliminary way, cognitive behavioral therapy and the use of Spray THC/CBD oromucous has the potential to have a beneficial impact on quality of life.

show abstract

Interventions for treating neuropathic pain in people with sickle cell disease

Abstract: Interventions for treating neuropathic pain in people with sickle cell disease (Review)

Cited by 6 publications

References 61 publications

Optimizing the management of chronic pain in sickle cell disease

Optimizing the management of chronic pain in sickle cell disease

Targeting TRPV1 activity via high‐dose capsaicin in patients with sickle cell disease

Quality of life in neuropathic pain: a literature review

Contact Info

Product

Resources

About