Cardiovascular Risk of Non-Opioid Pain Medications
非阿片类止痛药的心血管风险
基本信息
- 批准号:10041689
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-01-01 至 2023-12-31
- 项目状态:已结题
- 来源:
- 关键词:AcetaminophenAddressAdrenergic AgentsAdverse drug effectAdverse effectsAmericanAmitriptylineAnalgesicsAnti-Inflammatory AgentsAnticonvulsantsAntidepressive AgentsAntiepileptic AgentsArrhythmiaAttentionAwarenessBindingBlood PressureCalciumCalcium ChannelCardiomyopathiesCardiotoxicityCardiovascular DiseasesCardiovascular systemCaringCase StudyCatecholaminesCessation of lifeChronicClinical TrialsComplexCongestive Heart FailureDataDatabasesDrug ControlsDrug PrescriptionsDrug ProspectingDrug Side EffectsDrug toxicityDrug usageEuropeanEventExerciseFaceFibromyalgiaGeneral PopulationGoalsGovernment AgenciesGuidelinesHealthHealth systemHeart ArrestHeart RateHeart failureHigh PrevalenceHypotensionInotropismKnowledgeLidocaineLifeLiquid substanceLong-Term EffectsLongitudinal StudiesMalignant NeoplasmsManufacturer NameMedicalMedical AssistanceMedicineMethodsMissionMuscle relaxantsMyocardial InfarctionNorepinephrineOpioidOpioid AnalgesicsOralOutcomeOutcome StudyOverdosePainPain managementPatientsPharmaceutical PreparationsPharmacoepidemiologyPharmacologyPlayPopulationRecording of previous eventsReportingResearchResearch PersonnelRetrospective cohort studyRiskRoleSafetySeriesSerotoninStress cardiomyopathyStructureSystemTachycardiaTechniquesTestingTimeToxic effectTramadolTreatment EfficacyUnited StatesUnited States Department of Veterans AffairsUnited States Food and Drug AdministrationVeteransVeterans Health AdministrationVulnerable Populationsactive comparatoractive controlattenuationcardiovascular risk factorcelecoxibchronic painchronic pain managementchronic pain patientcohortdesigndrug mechanismduloxetineepidemiology studyexperiencehigh dimensionalityhigh riskimprovedinhibitor/antagonistmedication safetymidalcipranmilitary veterannon-cancer chronic painnon-opioid analgesicnovelpregabalinpreventreuptakeside effectstudy populationvoltage
项目摘要
PROJECT SUMMARY
When compared to the general population, U.S. Military Veterans disproportionately experience pain, especially
severe pain. Indeed, pain management is one of the most common reasons Veterans seek medical assistance.
The U.S. Department of Veterans Affairs (VA) and Veterans Health Administration (VHA) have continued to
focus attention on chronic pain management, which has resulted in the implementation of new guidelines and
systems that prioritize non-opioid treatments.
Current pharmacologic alternatives to opioids for chronic pain management include: (1) topical and oral
analgesics such as lidocaine, acetaminophen, and non-steroidal anti-inflammatories (NSAIDs); (2)
antidepressants; (3) anticonvulsants; and (4) muscle relaxants. We and others have defined the cardiovascular
toxicity of NSAIDs and opioid analgesics, but the potential toxicity of other drug classes used to treat chronic
pain remains poorly defined. This is particularly important for three classes of drugs: (1) selective norepinephrine
reuptake inhibitors (SNRIs) antidepressants, (2) antiepileptics, and (3) muscle relaxants. Within each drug class,
duloxetine (SNRI), pregabalin (antiepileptic), and cyclobenzaprine (muscle relaxant) are among the most
frequently prescribed. Usage of these three drugs has generated multiple case reports and raised specific
concerns for increased risk of serious cardiovascular events.
Currently, hundreds of thousands of Veterans are filling prescriptions for these drugs each year, and the use of
non-opioid pain drugs is increasing. Veterans encompass a vulnerable population with high cardiovascular risk
and high rates of chronic pain; thus, they are at higher risk for adverse drug effects. The overwhelming majority
of Veterans with chronic pain do not have cancer or life-threatening illness, which makes the prospect of drug
toxicity from long-term use a particularly important consideration.
Clinical trials play a crucial role in demonstrating treatments' efficacy; however, many drugs have had unforeseen
and serious side effects. Since clinical trials necessarily are limited with regard to generalizability and can be
impractical, pharmacoepidemiologic studies play a critical role in our knowledge about the long-term side effects
of drugs. The proposed pharmacoepidemiologic studies seek to provide critical information about the
cardiovascular risks associated with three widely prescribed non-opioid medications used to treat chronic pain
and frequently prescribed to Veterans in the VA health system. We will use state of the art techniques and a
large database of Veterans to assemble a cohort of patients with chronic non-cancer pain. Aim 1 will define the
risk for serious cardiovascular outcomes in patients taking cyclobenzaprine. Aim 2 will define the risk of serious
cardiovascular events associated with the use of duloxetine. Aim 3 will define the risk of heart failure associated
in patients taking pregabalin. These studies will compare those risks with the risk observed in patients with
chronic pain taking two active comparators: tramadol and celecoxib. Our overarching goal to improve the health
of Veterans and prevent negative side effects makes these studies an excellent fit with the VA mission.
项目总结
项目成果
期刊论文数量(0)
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Cecilia Pilar Chung其他文献
Cecilia Pilar Chung的其他文献
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{{ truncateString('Cecilia Pilar Chung', 18)}}的其他基金
A Personalized Medicine Approach to Improve the Prediction of Azathioprine Toxicity
改善硫唑嘌呤毒性预测的个性化医疗方法
- 批准号:
10225430 - 财政年份:2018
- 资助金额:
-- - 项目类别:
A Personalized Medicine Approach to Improve the Prediction of Azathioprine Toxicity
改善硫唑嘌呤毒性预测的个性化医疗方法
- 批准号:
10453718 - 财政年份:2018
- 资助金额:
-- - 项目类别:
A Personalized Medicine Approach to Improve the Prediction of Azathioprine Toxicity
改善硫唑嘌呤毒性预测的个性化医疗方法
- 批准号:
10783440 - 财政年份:2018
- 资助金额:
-- - 项目类别:
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