Dampier Carlton, Palermo Tonya M, Darbari Deepika S, Hassell Kathryn, Smith Wally, Zempsky William
Emory University School of Medicine, Atlanta, Georgia.
Seattle Children's Research Institute, Seattle, Washington.
J Pain. 2017 May;18(5):490-498. doi: 10.1016/j.jpain.2016.12.016. Epub 2017 Jan 5.
Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria.
An evidence-based classification system for chronic SCD pain was constructed for the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative. Applying this taxonomy may improve assessment and management of SCD pain and accelerate research on epidemiology, mechanisms, and treatments for chronic SCD pain.
镰状细胞病(SCD)中的疼痛与发病率增加、死亡率上升以及高昂的医疗费用相关。尽管发作性急性疼痛是这种疾病的标志,但人们越来越意识到慢性疼痛是许多大龄青少年和成年人疼痛体验的一部分。一套用于对与SCD相关的慢性疼痛进行分类的通用标准将加强SCD疼痛在流行病学、疼痛机制以及疼痛管理干预措施临床试验方面的研究工作,并最终改善临床评估和管理。作为镇痛药、麻醉药和成瘾性药物临床试验转化创新机遇与网络公私合作项目与美国食品药品监督管理局以及美国疼痛协会合作努力的一部分,镇痛药、麻醉药和成瘾性药物临床试验转化创新机遇与网络 - 美国疼痛协会疼痛分类法倡议制定了慢性疼痛状况最佳诊断系统的大纲。随后,召集了一个SCD疼痛专家工作组,以制定与SCD相关的慢性疼痛的核心诊断标准。该工作组综合现有文献,为这种疾病特异性疼痛分类法的各个维度提供证据。得出了一种单一的疼痛状况,标记为慢性SCD疼痛,并带有反映不同临床特征的3个修饰词。未来需要进行系统研究,以评估这些标准的可行性、有效性和可靠性。
为镇痛药、麻醉药和成瘾性药物临床试验转化创新机遇与网络 - 美国疼痛协会疼痛分类法倡议构建了一个基于证据的慢性SCD疼痛分类系统。应用这种分类法可能会改善SCD疼痛的评估和管理,并加速对慢性SCD疼痛的流行病学、机制和治疗方法的研究。