Witter James, Dionne Raymond A
Center for Drug Evaluation & Research (CDER), FDA, Rockville, Maryland, USA.
Arthritis Res Ther. 2004;6(6):279-81. doi: 10.1186/ar1450. Epub 2004 Oct 15.
Chronic pain remains an important public health need with greater impact on the US economy than most other chronic conditions. Current pain management is largely limited to opioids and non-steroidal anti-inflammatory drugs, indicating a gap in the translation of new knowledge to the development of improved pain treatments. Strategies suggested include the re-evaluation of current drug screening methods, a recognition that molecular-genetic events occurring acutely contribute to the development of pain chronicity, the validation of analgesic targets in the intended patient population, consideration of the unique genetic profile that varies between individuals, and the introduction of individual response measures to improve the capture of outcomes in clinical trials.
慢性疼痛仍是一项重要的公共卫生需求，对美国经济的影响比大多数其他慢性病更大。目前的疼痛管理主要局限于阿片类药物和非甾体抗炎药，这表明在将新知识转化为改进的疼痛治疗方法方面存在差距。建议的策略包括重新评估当前的药物筛选方法，认识到急性发生的分子遗传事件会导致疼痛慢性化的发展，在目标患者群体中验证镇痛靶点，考虑个体之间不同的独特基因谱，以及引入个体反应测量方法以改善临床试验中结果的获取。
