Towards an Effective and Safe Treatment of Inflammatory Pain: A Delphi-Guided Expert Consensus.
- Varrassi G Paolo Procacci Foundation, Rome, Italy. giuvarr@gmail.com.
- Alon E University of Zurich, Zurich, Switzerland.
- Bagnasco M Medical Affairs Department, Dompé Farmaceutici SpA, Milan, Italy.
- Lanata L Medical Affairs Department, Dompé Farmaceutici SpA, Milan, Italy.
- Mayoral-Rojals V University of Belvitge, Barcellona, Spain.
- Paladini A Department of MESVA, University of L'Aquila, L'Aquila, Italy.
- Pergolizzi JV NEMA Research Inc, Naples, FL, USA.
- Perrot S Descartes University and Cochin-Hotel Dieu Hospital, Paris, France.
- Scarpignato C University of Parma, Parma, Italy.
- Tölle T University of Munich, Munich, Germany.
- 2019-09-06
Published in:
- Advances in therapy. - 2019
Adjuvant drugs
Inflammation
Inflammatory pain
NSAIDs
Neurogenic pain
Neuroinflammation
Opioids
Pain
Acetaminophen
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Consensus
Health Knowledge, Attitudes, Practice
Humans
Inflammation
Pain
Pain Management
English
OBJECTIVE
The clinical management of inflammatory pain requires an optimal balance between effective analgesia and associated safety risks. To date, mechanisms associated with inflammatory pain are not completely understood because of their complex nature and the involvement of both peripheral and central mechanisms. This Expert Consensus document is intended to update clinicians about evolving areas of clinical practice and/or available treatment options for the management of patients with inflammatory pain.
METHOD
An international group of experts in pain management covering the pharmacology, neurology and rheumatology fields carried out an independent qualitative systematic literature search using MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials.
RESULTS
Existing guidelines for pain management provide recommendations that do not satisfactorily address the complex nature of pain. To achieve optimal outcomes, drug choices should be individualized to guarantee the best match between the characteristics of the patient and the properties of the medication. NSAIDs represent an important prescribing choice in the management of inflammatory pain, and the recent results on paracetamol question its appropriate use in clinical practice, raising the need for re-evaluation of the recommendations in the clinical practice guidelines.
CONCLUSIONS
Increasing clinicians' knowledge of the available pharmacologic options to treat different pain mechanisms offers the potential for safe, individualized treatment decisions. We hope that it will help implement the needed changes in the management of inflammatory pain by providing the best strategies and new insights to achieve the ultimate goal of managing the disease and obtaining optimal benefits for patients.
FUNDING
Dompé Farmaceutici SPA and Paolo Procacci Foundation.
The clinical management of inflammatory pain requires an optimal balance between effective analgesia and associated safety risks. To date, mechanisms associated with inflammatory pain are not completely understood because of their complex nature and the involvement of both peripheral and central mechanisms. This Expert Consensus document is intended to update clinicians about evolving areas of clinical practice and/or available treatment options for the management of patients with inflammatory pain.
METHOD
An international group of experts in pain management covering the pharmacology, neurology and rheumatology fields carried out an independent qualitative systematic literature search using MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials.
RESULTS
Existing guidelines for pain management provide recommendations that do not satisfactorily address the complex nature of pain. To achieve optimal outcomes, drug choices should be individualized to guarantee the best match between the characteristics of the patient and the properties of the medication. NSAIDs represent an important prescribing choice in the management of inflammatory pain, and the recent results on paracetamol question its appropriate use in clinical practice, raising the need for re-evaluation of the recommendations in the clinical practice guidelines.
CONCLUSIONS
Increasing clinicians' knowledge of the available pharmacologic options to treat different pain mechanisms offers the potential for safe, individualized treatment decisions. We hope that it will help implement the needed changes in the management of inflammatory pain by providing the best strategies and new insights to achieve the ultimate goal of managing the disease and obtaining optimal benefits for patients.
FUNDING
Dompé Farmaceutici SPA and Paolo Procacci Foundation.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1007/s12325-019-01053-x
- PMID 31485978
- Persistent URL
- https://sonar.ch/global/documents/298742
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