Showing papers by "Michael C. Rowbotham published in 2017"
University of Rochester1, University of Washington2, Johns Hopkins University School of Medicine3, University of Oxford4, Harvard University5, University of Michigan6, University of Colorado Boulder7, Aalborg University8, University of Maryland, Baltimore9, Tufts University10, Eli Lilly and Company11, University of Pennsylvania12, Queen's University13, Pfizer14, Janssen Pharmaceutica15, Aarhus University16, Duke University17, Boston Children's Hospital18, Bristol-Myers Squibb19, Imperial College London20, California Pacific Medical Center21, University of Pittsburgh22, National Institutes of Health23
TL;DR: Although sensory testing, skin punch biopsy, and brain imaging are promising tools for pain in clinical trials, additional evidence is needed to further support and standardize these tests for use as biomarkers in pain clinical trials.
121 citations
Walter Reed Army Institute of Research1, University of Florida2, Center for Drug Evaluation and Research3, University of Iowa4, Vanderbilt University Medical Center5, University of Michigan6, Uniformed Services University of the Health Sciences7, Rush University Medical Center8, Beth Israel Deaconess Medical Center9, University of Rochester Medical Center10, University of Washington11, Medical College of Wisconsin12, University of Copenhagen13, Stanford University14, University of North Carolina at Chapel Hill15, University of Pennsylvania16, University of California, Los Angeles17, Johns Hopkins University18, University of California, San Francisco19, Northwestern University20, Yale University21, Brigham and Women's Hospital22, University of Washington Medical Center23, Children's Hospital of Wisconsin24, Tufts University25
TL;DR: The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: core criteria, common features, modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.
51 citations
TL;DR: The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.
Abstract: Objective With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (e.g., pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain. Setting Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM). Methods As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions. Perspective The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Conclusions Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.
43 citations
TL;DR: Examination of primary reports of randomized clinical trials in six high-impact, general medical journals reported whether or not a Data Monitoring Committee/Data and Safety Monitoring Board (DMC/DSMB) was used and the composition of the responsibilities of the reported DSMB/DMCs recommended increased transparency regarding study conduct.
7 citations
01 Jan 2017
TL;DR: Aggressive treatment of acute herpes zoster with antiviral drugs, glucocorticoids, and opioid and non-opioid analgesics may prevent PHN by reducing viral replication, inflammation, and central sensitization, respectively.
Abstract: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster. Because treatment of this debilitating chronic pain syndrome is often unsatisfying, attention has shifted to identifying strategies for preventing the transition from acute zoster pain to PHN. Aggressive treatment of acute herpes zoster with antiviral drugs, glucocorticoids, and opioid and non-opioid analgesics may prevent PHN by reducing viral replication, inflammation, and central sensitization, respectively. The antiviral drug acyclovir has been studied most extensively, with several randomized controlled trials and systematic reviews supporting a modest effect in the acute phase, but firm conclusions regarding prevention of PHN are precluded by inadequate methods and reporting. The newer antiviral drugs valacyclovir and famciclovir have been demonstrated to be superior to acyclovir with regard to both acute and chronic outcomes, stressing their importance in the acute phase. The effects of glucocorticoids, opioids, and non-opioid analgesic treatments have been examined in only a few trials, most of which are either inconclusive or outdated, because treatment was provided alone rather than as a supplement to antiviral therapy. Nevertheless, glucocorticoids, oxycodone, gabapentin, and pregabalin may alleviate acute neuralgia and deserve more study in the acute phase.
4 citations