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Antirheumatic Indications for Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Includes drugs indicated for different types of arthritis as well as the form and strength the medication is available in.

Antirheumatic Indications for Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)


Orginally Published At: Musculoskeletal Pain

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Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

imageIntroduction:
Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in “pharmacologically cured” patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient’s quality of life, daily activities, and mood.
Objectives:
The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy.
Methods:
Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on drugs prescribed for neuropathic pain and their respective pain relief.
Results:
The pain characteristics based on NPSI did not significantly differ between leprosy and nonleprosy neuropathic pain patients in visit 1 after correction for multiple analyses, and cluster analyses confirmed these findings (ie, no discrimination between leprosy and nonleprosy groups; Pearson χ2 = 0.072, P = 0.788). The assessment of pain relief response and the drugs taken by each patient, linear regression analysis showed that amitriptyline, when effective, had the highest percentage of analgesic relief.
Conclusions:
Neuropathic pain in leprosy is as heterogeneous as neuropathic pain of other etiologies, further supporting the concept that neuropathic pain is a transetiological entity. Neuropathic pain in leprosy may respond to drugs usually used to control pain of neuropathic profile in general, and amitriptiline may constitute a potential candidate drug for future formal clinical trials aimed at controlling neuropathic pain in leprosy.

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies


Orginally Published At: PAIN Reports

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Research Design Characteristics of Published Pharmacologic Randomized Clinical Trials for Irritable Bowel Syndrome and Chronic Pelvic Pain Conditions: An ACTTION Systematic Review

Chronic pain conditions occurring in the lower abdomen and pelvis are prevalent, often challenging to manage, and can negatively affect health-related quality of life, including psychosocial and sexual well-being.3,8,25,27,32,37 Very few U.S. Food and Drug Administration (FDA) or European Medicines Agency (EMA) approved treatments currently exist for these conditions. The dearth of treatments arises, in part, from methodological challenges in designing randomized clinical trials (RCTs) to evaluate the efficacy of novel treatments in these conditions.

Research Design Characteristics of Published Pharmacologic Randomized Clinical Trials for Irritable Bowel Syndrome and Chronic Pelvic Pain Conditions: An ACTTION Systematic Review

Orginally Published At: Pain Journal

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A Kappa Opioid Receptor Agonist Blocks Bone Cancer Pain Without Altering Bone Loss, Tumor Size, or Cancer Cell Proliferation in a Mouse Model of Cancer-Induced Bone Pain

Tumor growth within bone is associated with moderate to severe pain. Pain is the most feared consequence of cancer and greatly diminishes the patient’s quality of life.5,34 Mu opioid receptor (MOR)-mediated drugs such as morphine and fentanyl remain the gold standard for the treatment of moderate to severe cancer pain including ongoing and breakthrough cancer pain.1 However, the severity of cancer pain generally requires high doses, and sustained treatment leads to tolerance, which leads to dose escalation.

A Kappa Opioid Receptor Agonist Blocks Bone Cancer Pain Without Altering Bone Loss, Tumor Size, or Cancer Cell Proliferation in a Mouse Model of Cancer-Induced Bone Pain

Orginally Published At: Pain Journal

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Is the Nociception Mechanism Altered in Offspring of Morphine-Abstinent Rats?

Family, twin, and adoption studies have yielded enormous amounts of valuable information about drug dependence as a multifactorial and polygenic disorder.30,32 Chronic drug exposure renders lasting molecular and cellular changes in the central nervous system including alternations in gene expression, mRNA level, protein level, and synaptic plasticity.39 Molecular as well as behavioral studies indicate that addictive substances induce long-lasting changes in the behavior and gene expression in some brain regions involved in reward circuit.

Is the Nociception Mechanism Altered in Offspring of Morphine-Abstinent Rats?

Orginally Published At: Pain Journal

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Sensory symptom profiles differ between trigeminal and thoracolumbar postherpetic neuralgia

imageIntroduction:
Animal experimental evidence suggests that mechanisms of pain generation and response to treatment differ between neuropathic pain in the cephalic and the extracephalic innervation territories.
Objectives:
The objective of the study was to examine whether in humans an identical peripheral painful neuropathy is associated with different pain qualities and sensory abnormalities in the face as compared with the thoracic region.
Methods:
We retrospectively analysed epidemiological and clinical data of 639 patients with postherpetic neuralgia (PHN) in the face and at the trunk who were collected within a cross-sectional cohort survey and compared the respective sensory symptom profiles captured with the painDETECT questionnaire.
Results:
Two hundred twenty-four patients suffered from trigeminal PHN and 415 from thoracolumbar PHN. There were no significant differences in sex-ratio, age, body mass index, and pain duration. Patients with trigeminal PHN were more often severely depressed. Anxiety and sleep scores were not different. The average pain intensity was slightly higher in thoracolumbar PHN than trigeminal PHN (visual analogue scale 5.0 vs 4.6). Postherpetic neuralgia in the thoracolumbar region showed significantly more intense burning sensations, allodynia, painful attacks, and significantly less prickling and numbness than PHN in the face.
Conclusions:
The differences in sensory symptom profiles between facial PHN and truncal PHN might be associated with different pathophysiological mechanisms and different treatment response. Drugs that primarily act on sensitization processes in the peripheral nociceptive system may work better in thoracolumbar PHN than in trigeminal PHN. If new medications are tested in patients with PHN, it would therefore be of interest to include an analysis of the treatment results in regard to subgroups based on the localisation of pain in patients with PHN.

Sensory symptom profiles differ between trigeminal and thoracolumbar postherpetic neuralgia


Orginally Published At: PAIN Reports