Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital, Kiel, Germany.
Clin Pharmacol Ther. 2015 Feb;97(2):135-42. doi: 10.1002/cpt.19. Epub 2014 Dec 15.
Patients with the same disease may suffer from completely different pain symptoms yet receive the same drug treatment. Several studies elucidate neuropathic pain and treatment response in human surrogate pain models. They show promising results toward a patient stratification according to the mechanisms underlying the pain, as reflected in their symptoms. Several promising new drugs produced negative study results in clinical phase III trials. However, retrospective analysis of treatment response based on baseline pain phenotyping could demonstrate positive results for certain subgroups of patients. Thus, a prospective classification of patients according to pain phenotype may play an increasingly important role in personalized treatment of neuropathic pain states. A recent prospective study using stratification based on pain-related sensory abnormalities confirmed the concept of personalized pharmacological treatment of neuropathic pain.
患有同种疾病的患者可能会经历完全不同的疼痛症状，但却接受相同的药物治疗。有几项研究阐明了人类替代疼痛模型中的神经病理性疼痛和治疗反应。这些研究结果表明，根据疼痛的潜在机制对患者进行分层具有很大的前景，正如他们的症状所反映的那样。一些很有前途的新药在临床三期试验中产生了负面的研究结果。然而，基于基线疼痛表型的治疗反应回顾性分析可以为某些特定亚组的患者带来阳性结果。因此，根据疼痛表型对患者进行前瞻性分类可能在神经病理性疼痛状态的个体化治疗中发挥越来越重要的作用。最近一项使用基于与疼痛相关的感觉异常进行分层的前瞻性研究证实了对神经病理性疼痛进行个体化药物治疗的概念。
