Department of Anesthesiology, Center for Pain Medicine, Erasmus MC University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Drugs. 2022 Apr;82(5):511-531. doi: 10.1007/s40265-022-01685-4. Epub 2022 Mar 5.
Complex regional pain syndrome (CRPS) is a debilitating painful condition of a distal extremity that can develop after tissue damage. CRPS is thought to be a multimechanism syndrome and ideally the most prominent mechanism(s) should be targeted by drugs in an individually tailored manner. This review gives an overview of the action and evidence of current and future pharmacotherapeutic options for CRPS. The available options are grouped in four categories by their therapeutic actions on the CRPS mechanisms, i.e. inflammation, central sensitisation, vasomotor disturbances and motor disturbances. More knowledge about the underlying mechanisms of CRPS helps to specifically target important CRPS mechanisms. In the future, objective biomarkers could potentially aid in selecting appropriate mechanism-based drugs in order to increase the effectiveness of CRPS treatment. Using this approach, current and future pharmacotherapeutic options for CRPS should be studied in multicentre trials to prove their efficacy. The ultimate goal is to shift the symptom-based selection of therapy into a mechanism-based selection of therapy in CRPS.
复杂性区域疼痛综合征（CRPS）是一种肢体远端的使人虚弱的疼痛疾病，可在组织损伤后发生。CRPS 被认为是一种多机制综合征，理想情况下，药物应根据个体情况以最突出的机制为靶点进行靶向治疗。这篇综述概述了目前和未来用于 CRPS 的药物治疗选择的作用和证据。根据它们对 CRPS 机制的治疗作用，现有选择分为四类，即炎症、中枢敏化、血管运动障碍和运动障碍。更多关于 CRPS 潜在机制的知识有助于有针对性地针对重要的 CRPS 机制。将来，客观的生物标志物可能有助于根据潜在的机制选择合适的药物，从而提高 CRPS 治疗的效果。通过这种方法，应在多中心试验中研究当前和未来用于 CRPS 的药物治疗选择，以证明其疗效。最终目标是将基于症状的治疗选择转变为基于机制的 CRPS 治疗选择。
