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Real-World Prescription Data for Intrathecal Drug Delivery: A Retrospective Analysis in 32,784 Patients.
Neuromodulation
September 2024
Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Beth Israel Lahey Health, Boston, MA, USA.
Objectives: Currently, there are three monotherapy drugs approved by the United States Food and Drug Administration (FDA) for use in intrathecal drug delivery systems (IDDS): morphine, ziconotide, and baclofen. In practice, use includes alternate drugs, drug combinations, and drug concentrations. There is a paucity of real-world data examining prescription patterns for IDDS.
View Article and Find Full Text PDFCombination Intrathecal Drug Therapy Strategies for Pain Management.
Pain Physician
December 2021
Department of Anesthesiology University of Wisconsin, School of Medicine and Public Health, Madison, WI.
Background: Numerous combination intrathecal drug therapy (CIDT) strategies exist and are utilized for varying pain syndromes, typically when monotherapy dose escalation or medication alternation is deemed untenable or unfeasible. Unfortunately, the supportive evidence basis for the use of these strategies and specific drug combinations is generally lacking and unclear, with many medications being used for off-label indications.
Objective: In this manuscript, we provide a robust exploration and analysis of the literature to provide an evidence-based narrative for the use of CIDT strategies in regard to clinical indications, pharmacologic parameters, specific drug combinations, safety profiles, and future directions.
Periplasmic Expression of 4/7 α-Conotoxin TxIA Analogs in Favors Ribbon Isomer Formation - Suggestion of a Binding Mode at the α7 nAChR.
Front Pharmacol
May 2019
Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
Peptides derived from animal venoms provide important research tools for biochemical and pharmacological characterization of receptors, ion channels, and transporters. Some venom peptides have been developed into drugs (such as the synthetic ω-conotoxin MVIIA, ziconotide) and several are currently undergoing clinical trials for various clinical indications. Challenges in the development of peptides include their usually limited supply from natural sources, cost-intensive chemical synthesis, and potentially complicated stereoselective disulfide-bond formation in the case of disulfide-rich peptides.
View Article and Find Full Text PDFIntrathecal Pain Therapy for the Management of Chronic Noncancer Pain.
Neurosurg Clin N Am
April 2019
AMC Department of Neurosurgery, 47 New Scotland Avenue, MC10, Albany, NY 12208, USA. Electronic address:
Intrathecal drug delivery has been well established an effective and safe method for the treatment of pain, including palliative cancer-related and chronic nonmalignant pain. In this article, we discuss the role of intrathecal pain therapy in the management of chronic, refractory nonmalignant pain. Common indications, patient selection criteria, medication options, complications, and adverse events are discussed within the context of results from randomized controlled trials, clinical consensus guidelines, and best available literature to date.
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