Maximizing treatment efficacy through patient stratification in neuropathic pain trials
Maximizing treatment efficacy through patient stratification in neuropathic pain trials
复制标题
DOI：
10.1038/s41582-022-00741-7
复制
发表时间：
2022-11-18
影响因子：
38.1
通讯作者：
Bennett, David L.
中科院分区：
文献类型：
--
作者：
Baron, Ralf;Dickenson, Anthony H.;Bennett, David L.
尽管研究取得了重大进展，但神经性疼痛的治疗仍然不足，且对治疗的反应差异很大。在这篇《观点》文章中，作者认为，对神经性疼痛患者进行合理分层将有助于确定哪些患者亚组能从特定治疗中获益最大。尽管多种病理生理机制已得到阐明，且有前景的治疗化合物也已研发出来，但神经性疼痛的治疗仍然不足。将知识转化为临床实践的不成功使制药公司不愿投资于疼痛医学；然而，新的患者分层方法可能有助于弥合转化差距，并开发个体化的治疗方法。正如我们在本文中所强调的，根据感觉特征和其他基线特征对患者进行分组可能有助于预测治疗是否成功。此外，针对神经性疼痛患者已经开发出了新的疗效评估指标。感觉特征和疗效评估指标在常规临床实践和临床试验中以及在不同病因的神经性疼痛中的应用程度还有待确定。需要改进动物模型（利用我们对人类疼痛的了解），并建立稳固的公私合作伙伴关系，以便为未来创新且有效的疼痛医学铺平道路。
Despite substantial research advances, treatment of neuropathic pain remains inadequate and responses to treatment are highly variable. In this Perspective, the authors argue that rational stratification of patients with neuropathic pain will aid identification of subgroups of patients who will benefit most from a given treatment.Treatment of neuropathic pain remains inadequate despite the elucidation of multiple pathophysiological mechanisms and the development of promising therapeutic compounds. The lack of success in translating knowledge into clinical practice has discouraged pharmaceutical companies from investing in pain medicine; however, new patient stratification approaches could help bridge the translation gap and develop individualized therapeutic approaches. As we highlight in this article, subgrouping of patients according to sensory profiles and other baseline characteristics could aid the prediction of treatment success. Furthermore, novel outcome measures have been developed for patients with neuropathic pain. The extent to which sensory profiles and outcome measures can be employed in routine clinical practice and clinical trials and across distinct neuropathic pain aetiologies is yet to be determined. Improvements in animal models, drawing on our knowledge of human pain, and robust public-private partnerships will be needed to pave the way to innovative and effective pain medicine in the future.