Publications by authors named "Didier Bouhassira"
Objective: In rheumatoid arthritis (RA) and spondyloarthritis (SpA), managing persistent pain remains challenging. Little is known regarding impaired pain pathways in these patients and the impact of bDMARDs. The objective of the RAPID (Rheumatism Pain Inhibitory Descending pathways) study was to assess pain thresholds and descending pain modulation in patients with active RA or SpA following introduction of a TNF inhibitor.
View Article and Find Full Text PDFArticle Synopsis
- E-52862, a selective sigma-1 receptor antagonist, was tested for its effectiveness and safety in treating chronic pain conditions (CPSP and PDN) through phase 2 randomized studies involving adult patients.
- In CPSP patients, E-52862 showed a greater reduction in pain intensity compared to placebo after 4 weeks, while no significant difference was found in PDN patients likely due to a high response rate to placebo.
- Although the treatment had a higher incidence of adverse events in CPSP patients compared to placebo, overall, E-52862 was deemed tolerable and effective in providing meaningful pain relief for chronic postsurgical pain.
Article Synopsis
- The study explored genetic links to neuropathic pain by comparing individuals with the condition to those who had injuries but did not experience neuropathic pain.
- Key findings included significant associations with the KCNT2 gene and pain intensity, as well as other genes like LHX8 and TCF7L2 connected to neuropathic pain.
- The research also highlighted the influence of polygenic risk scores related to depression and inflammation on neuropathic pain, while discovering novel genetic variants tied to specific sensory profiles.
Article Synopsis
- The study investigates the reasons behind why some patients experience painful polyneuropathy while others do not, utilizing data from 1181 patients in the DOLORISK database.
- Researchers used multivariate logistic regression and machine learning to identify key factors related to painful neuropathy, including severity of neuropathy, family history of chronic pain, fatigue, depression scores, and pain-related worrying.
- The findings suggest that emotional and clinical factors play a significant role in the development of painful neuropathy, with predictive models achieving over 76% accuracy, which could help in identifying patients at risk in the future.
A systematic literature review on patient-reported outcome domains and measures in nonsurgical efficacy trials related to chronic pain associated with endometriosis: an urgent call to action.
Pain
November 2024
Endometriosis, a common cause for chronic pelvic pain, significantly affects quality of life, fertility, and overall productivity of those affected. Therapeutic options remain limited, and collating evidence on treatment efficacy is complicated. One reason could be the heterogeneity of assessed outcomes in nonsurgical clinical trials, impeding meaningful result comparisons.
View Article and Find Full Text PDFDeveloping consensus on core outcome sets of domains for acute, the transition from acute to chronic, recurrent/episodic, and chronic pain: results of the INTEGRATE-pain Delphi process.
EClinicalMedicine
December 2023
Background: Pain is the leading cause of disability worldwide among adults and effective treatment options remain elusive. Data harmonization efforts, such as through core outcome sets (COS), could improve care by highlighting cross-cutting pain mechanisms and treatments. Existing pain-related COS often focus on specific conditions, which can hamper data harmonization across various pain states.
View Article and Find Full Text PDFPhase 2a of the PUCCINI study was a placebo-controlled, double-blind, parallel-group, multicenter, proof-of-concept study evaluating the efficacy and safety of the selective P2X3 antagonist eliapixant in patients with diabetic neuropathic pain (DNP) ( ClinicalTrials.gov NCT04641273). Adults with type 1 or type 2 diabetes mellitus with painful distal symmetric sensorimotor neuropathy of >6 months' duration and neuropathic pain were enrolled and randomized 1:1 to 150 mg oral eliapixant twice daily or placebo for 8 weeks.
View Article and Find Full Text PDFArticle Synopsis
- A study compared the analgesic effects of "superficial" and "deep" repetitive transcranial magnetic stimulation (rTMS) in patients with central neuropathic pain, with 59 patients randomly assigned to receive active or sham stimulation using different coils.
- Results showed significant pain relief from both treatments compared to a sham, with immediate effects from the superficial stimulation and delayed but longer-lasting effects from the deep stimulation.
- Both stimulation types provided similar levels of pain relief, suggesting different mechanisms may be at play, and involved various secondary outcomes like pain interference and depression.
Article Synopsis
- * A study of 1,090 patients showed that 30% with neuropathic pain experienced PHS, while only 2% of healthy participants did, and its occurrence was not related to overall pain intensity.
- * PHS may indicate diminished function of small thermosensory fibers that detect temperature; recognizing it can assist in identifying small fiber loss in patients, making it easy for them to self-report.
Parkinson disease (PD) affects up to 2% of the general population older than 65 years and is a major cause of functional loss. Chronic pain is a common nonmotor symptom that affects up to 80% of patients with (Pw) PD both in prodromal phases and during the subsequent stages of the disease, negatively affecting patient's quality of life and function. Pain in PwPD is rather heterogeneous and may occur because of different mechanisms.
View Article and Find Full Text PDFBackground And Purpose: In these guidelines, we aimed to develop evidence-based recommendations for the use of screening questionnaires and diagnostic tests in patients with neuropathic pain (NeP).
Methods: We systematically reviewed studies providing information on the sensitivity and specificity of screening questionnaires, and quantitative sensory testing, neurophysiology, skin biopsy, and corneal confocal microscopy. We also analysed how functional neuroimaging, peripheral nerve blocks, and genetic testing might provide useful information in diagnosing NeP.
Article Synopsis
- There have been big improvements in understanding and studying neuropathic pain over the last few decades.
- Better tools, like questionnaires, help doctors figure out when people have this kind of pain, including new types related to COVID-19.
- Finding the best treatments is still tough, and new methods, like combining different medicines and using techniques that don't involve drugs, are being explored for better care.
Background: The treatment of neuropathic pain remains a major unmet need that the development of personalized and refined treatment strategies may contribute to address.
Database: In this narrative review, we summarize the various approaches based on objective biomarkers or clinical markers that could be used.
Results: In principle, the validation of objective biomarkers would be the most robust approach.