在将疼痛知识转化为实践中学到的经验教训
Juliane Becker1, Philip R Effraim2,3, Sulayman Dib-Hajj3,4
1Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Center for Interdisciplinary Pain Medicine, University Hospital Würzburg, Würzburg, Germany.
Pain reports
|November 6, 2023
概括
尽管疼痛研究取得了进展,但超越当前选择的新型止痛药仍然难以捉摸. 由于疗效或安全问题,在临床试验中失败了三个有希望的目标 - 神经生长因子,NaV1.7通道和神经素受体.
科学领域:
- 疼痛研究 疼痛研究
- 药理学 药理学是指药理学的学科.
- 临床试验中的临床试验.
背景情况:
- 几十年的研究旨在开发超越阿片类药物和NSAIDs的新型止痛药.
- 取得的成功有限,很少有新的药物到达临床医生手中.
研究的目的:
- 审查三种新型疼痛治疗药物标的证据.
- 探索临床试验在疼痛管理方面的失败原因.
主要方法:
- 对现有的最佳证据和实践进行选择性审查.
- 专注于与IASP全球年度一致的临床更新.
- 对三个代表性点分子的分析:神经生长因子,NaV1.7和神经素受体.
主要成果:
- 神经生长因子抗体显示有效,但导致关节置换需要.
- NaV1.7 阻断剂缺乏足够的疗效,可能是由于缺乏患者分层.
- 神经素受体抑制剂也被证明是不够有效的.
- 失败的主要原因是缺乏疗效,较少情况下是严重的副作用.
结论:
- 临床试验失败凸显了改善临床前模型和患者分层的需要.
- 增强的分子表型和患者分层对于未来的药物开发至关重要.
- 利益相关者之间的合作,包括更好的临床前研究和患者参与,对于推进止痛药发现至关重要.
相关概念视频
Pain
482
Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
482
Analgesia and Pain Management
634
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
634
Nociception
27.9K
Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
27.9K
Techniques of therapeutic communication I: Active Listening, Sharing Observations, Validation, and Using Touch
4.9K
The history of therapeutic communication can be traced back to Florence Nightingale, who emphasized the importance of developing trusting relationships with patients. She taught that the presence of nurses with patients results in therapeutic healing.
Therapeutic communication is not the same as social interaction. Social interaction has no goal or purpose and consists of casual information sharing, whereas therapeutic communication has a plan or purpose for the conversation. Therapeutic...
Therapeutic communication is not the same as social interaction. Social interaction has no goal or purpose and consists of casual information sharing, whereas therapeutic communication has a plan or purpose for the conversation. Therapeutic...
4.9K
Blood and Nerve Supply to the Bones
11.1K
Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
11.1K


