Pain and Therapy最新文献

{"title":"Anterior Quadratus Lumborum Block: A Scoping Review of Anatomical Rationale, Techniques, and Clinical Applications.","authors":"Burhan Dost, Cengiz Kaya, Esra Turunc, Yunus Emre Karapinar, Madan Narayanan, Kiran Koneti, Dario Bugada, Alessandro De Cassai, Bayram Ufuk Sakul, Edward R Mariano, Hesham Elsharkawy","doi":"10.1007/s40122-026-00846-7","DOIUrl":"https://doi.org/10.1007/s40122-026-00846-7","url":null,"abstract":"<p><strong>Introduction: </strong>The anterior quadratus lumborum block (aQLB) is a fascial plane block targeting the interfascial plane between the quadratus lumborum and psoas major muscles, aiming to achieve both somatic and visceral analgesia through potential spread of local anesthetic toward the thoracolumbar nerve roots. Despite years of clinical use and a growing body of randomized trials across different surgical settings, uncertainty remains regarding its mechanisms of action, patterns of local anesthetic spread, and overall clinical effectiveness. This scoping review aimed to systematically map and synthesize the available evidence on aQLB and identify key knowledge gaps relevant to clinical practice and future research.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library was conducted from database inception to February 14, 2026. The search terms included variations of aQLB and related terminology. Only randomized controlled trials were included in this review.</p><p><strong>Results: </strong>A total of 1174 records were identified, of which 360 underwent full-text assessment, and 119 randomized controlled trials were included. Most studies were conducted in Asia (63%) and involved adults (92%). Abdominal and urological procedures were the most commonly studied surgical indications (56%), followed by orthopedic surgeries (26%) and obstetric-gynecological procedures (17%). Multiple aQLB variants have been reported, including transmuscular, subcostal anterior, supra-arcuate ligament, and lateral arcuate ligament approaches. Comparators included sham or no block, wound infiltration, transversus abdominis plane block, erector spinae plane block, paravertebral block, neuraxial techniques, and other regional techniques. Across studies, the aQLB generally reduced postoperative pain scores, opioid consumption, and postoperative nausea and vomiting. However, the findings were heterogeneous and varied by surgical procedure and study design.</p><p><strong>Conclusions: </strong>The available literature suggests that aQLB may provide effective postoperative analgesia and opioid-sparing benefits across different surgical procedures. However, inconsistent findings among studies, the limited number of well-designed randomized controlled trials, and substantial heterogeneity across surgical populations restrict the strength of the current conclusions. Moreover, the deep anatomical location of the block, technical complexity, and potential risks should be considered when evaluating its role in routine clinical practice.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Characteristics and Treatment Patterns of Calcitonin Gene-Related Peptide Monoclonal Antibody Users: a Japanese Claims Database-Based Study.","authors":"Tsubasa Takizawa, Ryo Takemura, Kaname Ueda, Yasuhiro Miki, Chie Hashimoto","doi":"10.1007/s40122-026-00843-w","DOIUrl":"https://doi.org/10.1007/s40122-026-00843-w","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding real-world calcitonin gene-related peptide monoclonal antibodies' (CGRP mAbs) use in patients with migraine is necessary to potentially guide treatment strategies.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed administrative claims data from the IQVIA claims data for Japan. It included CGRP mAb-naïve individuals with confirmed migraine diagnosis and ≥ 1 CGRP mAb prescription (January 2021-June 2023). Index date was the first CGRP mAb prescription. Patient characteristics, treatment patterns, adherence (proportion of days covered ≥ 0.80), persistence, and migraine-related direct costs were assessed. Persistence was measured as the proportion of patients continuing treatment for ≥ 3 or ≥ 6 months (≤ 90-day gap between fills). Factors predicting adherence to CGRP mAb treatment were assessed using multivariate logistic regression. Subgroup analyses were conducted for galcanezumab users.</p><p><strong>Results: </strong>Of the 1781 patients included (mean age 41.8 years [standard deviation, SD 10.3]; 79.3% female patients), 55.0% received galcanezumab, followed by fremanezumab (29.7%), and erenumab (15.3%). The prescription rates of concomitant acute and oral preventive medications were 86.1% and 51.3%, respectively, in the first 3 months after initiating CGRP mAb treatment but numerically decreased to 49.8% and 22.5%, respectively, in the fourth to sixth month. The index CGRP mAb persistence rates were 91.9% for ≥ 3 months and 76.9% for ≥ 6 months, and adherence rate was 51.7%. Multiple positive and negative predictors of adherence to CGRP mAbs were observed. Index to 3 months after initiating index CGRP mAbs, the median average monthly migraine-related costs were JPY 75,320 (Q1, Q3 61,593, 89,843) (USD 592), and non-CGRP mAb migraine-related costs were JPY 15,702 (Q1, Q3 8845, 27,848) (USD 123). These costs tended to reduce or plateau for up to 12 months thereafter. The galcanezumab subgroup showed a similar trend.</p><p><strong>Conclusions: </strong>CGRP mAb adherence and ≥ 6 months persistence rates were 51.7% and 76.9%, respectively, in CGRP mAb-initiating adults with migraine in Japan. During CGRP mAb treatment, acute and oral preventive medication prescription rates appeared to reduce, while direct costs initially increased but appeared to reduce from the post-initiation peak and plateau over time, although the underlying reasons could not be determined from claims data.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supraspinal Correlates of Patients with Chronic Pain Under Burst Spinal Cord Stimulation: A Proof-of-Concept Functional MRI Study.","authors":"Steffen Brenner, Achim Schilling, Patrick Krauss, Sherif Mohamed, Julia Fauth, Zohair Niroomand, Thomas Mehari Kinfe","doi":"10.1007/s40122-026-00841-y","DOIUrl":"https://doi.org/10.1007/s40122-026-00841-y","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is associated with central pain network-associated alterations. Functional MRI (fMRI) provides a powerful, non-invasive imaging technique to visualize such alterations. This feasibility study attempted to investigate the impact of BurstDR spinal cord stimulation (SCS) on fMRI correlates in patients with chronic pain.</p><p><strong>Methods: </strong>This proof-of-concept study included 11 patients (8 m/3 f; mean age 69.1 ± 11.2 years) with chronic back and/or leg pain with BurstDR SCS. Clinical outcomes were assessed at baseline and after 3 months BurstDR SCS (Numeric Rating Scale (NRS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Oswestry Disability Index (ODI)). fMRI (1.5 T) was obtained using a classic block-design motor with task and rest with single-subject and group analyses.</p><p><strong>Results: </strong>Pain decreased at follow-up (NRS: 7.3 ± 1.7 vs. 4.4 ± 1.5; p < 0.001) with improved functional capacity (PSQI: 10.2 ± 3.6 vs. 8.1 ± 2.7; p = 0.009; BDI: 16.9 ± 8.2 vs. 11.9 ± 6.3; p = 0.027; ODI: 56.5 ± 18.3 vs. 45.2 ± 16.4; p = 0.001). In the fMRI analyses, ten patients were included. Movement of the left foot led to significant activation in the medial region of the right precentral gyrus (Z > 3.1, p < 0.05). No differences at the predefined threshold for the entire brain were detected, although the uncorrected voxel-wise analysis showed several regions with increased activation post BurstDR SCS (bilateral middle temporal gyri (left: Z = 3.56, uncorrected p < 0.001; right: Z = 4.48, uncorrected p < 0.0001)). Functional connectivity analyses in 9 patients revealed no significant differences in task-modulated functional connectivity.</p><p><strong>Conclusions: </strong>BurstDR SCS reduced pain intensity and improved functional status associated with task-related activation of the motor cortex, which was reproducible across the entire cohort. Further randomized controlled studies are warranted to validate these findings and to elucidate the underlying mechanisms.</p><p><strong>Trial registration: </strong>German Clinical Trials Register (DRKS ID: DRKS00035826).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Next‑Generation SCS Programming Platform: Enhancing ECAP Fidelity and Objectivity to Improve Patient Experience.","authors":"Daniel J Parker, Ajay B Antony, Gregory L Smith, Johnathan H Goree, Marc A Russo, Erika A Petersen, Chau M Vu, Paul Verrills, Christopher Gilmore, Leonardo Kapural, Darayus Nanavati, Dean M Karantonis, Jason E Pope","doi":"10.1007/s40122-026-00838-7","DOIUrl":"https://doi.org/10.1007/s40122-026-00838-7","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results from TRIUMPH [EUROPE], a Real-World Observational Study on the 3-Month Effectiveness of Galcanezumab Versus Traditional Oral Migraine Preventive Medications.","authors":"Cristina Tassorelli, Diego Novick, Saygin Gonderten, Maurice Vincent, Rebecca L Robinson, Georgia Martimianaki, Patricia Pozo Rosich","doi":"10.1007/s40122-026-00839-6","DOIUrl":"https://doi.org/10.1007/s40122-026-00839-6","url":null,"abstract":"<p><strong>Introduction: </strong>Galcanezumab, a monoclonal antibody targeting calcitonin gene-related peptide, has shown efficacy in migraine prevention in clinical trials and has been included in clinical guidelines. Nonetheless, data on its real-world effectiveness are limited.</p><p><strong>Methods: </strong>TRIUMPH [Europe], an ongoing prospective study, enrolled patients ≥ 18 years old with migraine from Germany, Italy, Spain, and the UK who were initiating or switching to galcanezumab or traditional oral migraine preventive medications (TOMPs) between June 2020 and February 2023. The primary end point at 3 months was the percentage of patients achieving a response in monthly headache days (MHDs) as defined by a percentage reduction of ≥ 50% for episodic migraine and ≥ 30% for chronic migraine. The TRIUMPH [Europe] results are descriptive, as no alpha was allocated for comparative formal hypothesis testing between treatment groups.</p><p><strong>Results: </strong>A total of 717 patients were enrolled, with 46.0% in the galcanezumab and 40.9% in the TOMP groups. In the galcanezumab and TOMP groups, 85.8% and 85.3% of patients were women, respectively, and had a mean age of 44.4 and 36.8 years. Chronic migraine was more represented in the galcanezumab group than in the TOMP group (60.9% versus 32.4%). At baseline, mean (standard deviation [SD]) MHDs were 14.8 (7.2) for galcanezumab and 10.3 (5.2) days for TOMP. At 3 months, mean (SD) MHDs were 7.7 (7.4) and 6.8 (5.5) days for galcanezumab and TOMP, respectively. The 3-month weighted proportion of responders for galcanezumab and TOMP, respectively, was 63.1% and 34.9% overall, 60.7% and 29.9% for episodic migraines, and 65.0% and 42.6% for chronic migraines. Changes from baseline in the mean number of MHDs with acute medication use were -6.6 for galcanezumab and -2.9 for TOMP.</p><p><strong>Conclusions: </strong>After 3 months of migraine preventive treatment, the proportion of responders trended numerically higher among patients with migraine initiating/switching to galcanezumab than among those receiving TOMP.</p><p><strong>Trial registration: </strong>This study was registered through the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (number EUPAS33068).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Transcranial Magnetic Stimulation in Patients with Postherpetic Neuralgia and Comorbid Depression: A Randomized Controlled Trial.","authors":"Huichan Xu, Junpeng Yuan, Chen Zhao, Liqun Huang, Panqi Wang, Youjia Yu, Xiaohong Jin","doi":"10.1007/s40122-026-00840-z","DOIUrl":"https://doi.org/10.1007/s40122-026-00840-z","url":null,"abstract":"<p><strong>Introduction: </strong>Postherpetic neuralgia (PHN) frequently coexists with depression and remains associated with poor clinical outcomes despite interventional neuromodulation. Repetitive transcranial magnetic stimulation (rTMS) may lower the incidence of poor prognosis in this population. The aim of this trial was to evaluate the effect of perioperative rTMS in patients with PHN and comorbid depression undergoing neuromodulation.</p><p><strong>Methods: </strong>This randomized, single-center, sham-controlled trial was conducted at the First Affiliated Hospital of Soochow University in Jiangsu Province from February 2025 to November 2025. A total of 174 participants were randomly assigned, stratified by neuromodulation therapy, to receive either 10 Hz rTMS (n = 87) or sham stimulation (n = 87) targeting the primary motor cortex for five consecutive days. The primary outcome was the incidence of poor prognosis at 3 months.</p><p><strong>Results: </strong>The incidence of poor prognosis was significantly lower in the rTMS group compared with the sham group (27.4% versus 42.7%; odds ratio [OR] 0.51; 95% confidence interval [CI] 0.27-0.97; P = 0.039), corresponding to an absolute risk reduction of 15.3%. After adjusting for potential confounders, patients in the rTMS group were less likely to experience poor prognosis at 3 months than those in the sham group (adjusted OR, 0.47; 95% CI 0.23-0.95; P = 0.036).</p><p><strong>Conclusions: </strong>In this randomized controlled trial, perioperative rTMS reduced the risk of unfavorable clinical outcomes in patients with PHN and comorbid depression undergoing neuromodulation, without compromising safety. These findings support rTMS as a promising adjunctive therapeutic strategy in this population.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Register Identifier: ChiCTR2500096978.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter Prospective Study to Develop a Prediction Model for Postherpetic Neuralgia Using Clinical and Laboratory Indicators.","authors":"Jiaqi Wang, Yanbing Yao, Honggeng Wang, Jiaxiong Chen, Shulin Huang, Shiyuan Li, Ziheng Xiao, Jiewei Huang, Chunmei Fan","doi":"10.1007/s40122-026-00836-9","DOIUrl":"https://doi.org/10.1007/s40122-026-00836-9","url":null,"abstract":"<p><strong>Introduction: </strong>Postherpetic neuralgia (PHN) is the most common and difficult-to-treat complication of herpes zoster (HZ). This complication not only causes significant suffering but also imposes a substantial economic burden on patients. Early identification of patients at high risk and initiation of preventive interventions are crucial for reducing the burden of PHN. However, current clinical risk identification methods largely rely on subjective or semi-subjective clinical features and lack objective, easily accessible quantitative tools. This study aimed to develop and validate an efficient, objective, and clinically accessible prediction model for PHN risk by integrating routine clinical and laboratory indicators.</p><p><strong>Methods: </strong>This prospective, multicenter study consecutively enrolled 722 patients with acute HZ who presented at four hospitals in Quanzhou between September 2, 2024, and July 12, 2025. Clinical data were collected, and multiple laboratory indicators were obtained through centralized testing. In the training set, univariate and multivariate logistic regression analyses were performed to identify independent predictors significantly associated with PHN. Subsequently, based on these factors, multiple machine learning algorithms were evaluated for performance to select robust models, with their generalizability subsequently assessed on an independent test set.</p><p><strong>Results: </strong>The incidence of PHN was 18.84%. Multivariate analysis identified seven independent predictors of PHN: age, disease duration, prodromal pain, varicella-zoster virus immunoglobulin M (VZV-IgM), red cell distribution width-coefficient of variation (RDW-CV), urea, and serum sodium. The logistic regression model demonstrated the best predictive performance, achieving an area under the receiver operating characteristic curve (AUC) of 0.733 and accuracy of 0.765.</p><p><strong>Conclusion: </strong>This study provides the first report of PHN incidence among patients with HZ in Quanzhou. By integrating routine clinical and laboratory indicators, we successfully developed and validated a logistic regression model for predicting PHN risk. This model offers clinicians a practical tool for early identification of patients at high risk during the acute phase, thereby guiding timely preventive strategies.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Lipoproteins as Key Regulators in Neuropathic Pain: A Comprehensive Review of Mechanisms and Clinical Potential.","authors":"Hao Wei, Jiahua Shi, Jiabin Fan, Xiongjuan Li, Xinping Yang, Zhiheng Liu","doi":"10.1007/s40122-026-00830-1","DOIUrl":"https://doi.org/10.1007/s40122-026-00830-1","url":null,"abstract":"<p><p>Neuropathic pain (NP) is a complex chronic pain syndrome often secondary to conditions such as diabetic peripheral neuropathy and postherpetic neuralgia. It not only severely compromises patients' quality of life but also imposes a heavy burden on healthcare systems. Recent studies indicate that plasma lipoproteins play a significant role in its pathophysiology, with functions extending beyond lipid transport to include extensive involvement in inflammatory regulation, oxidative stress, and maintenance of neural function. This review aims to systematically elucidate the intricate relationship between NP and lipoproteins, analyze its pathophysiological mechanisms, and transcend conventional perspectives by conducting in-depth analyses of the specific mechanisms of action of high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) in pain. Consequently, it explores potential therapeutic strategies based on lipoprotein metabolism. This review demonstrates that distinct lipoprotein types exert critical roles in the initiation and maintenance of NP through differentiated mechanisms involving regulation of neuroinflammation, oxidative stress, and ion channel function. These findings not only expand our understanding of pain mechanisms but also provide theoretical foundations for developing novel therapeutic strategies targeting lipoprotein metabolism. Future clinical research is essential to advance these insights into safe and effective personalized analgesic approaches.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Selumetinib on Long-Term Pain Medication Utilization in Pediatric Patients: A Retrospective US Claims Database Study.","authors":"Genevieve Lyons, Theresa Dettling, Alyssa Bowling, Ashwin Anand, Michael Sicilia, Wouter van der Pluijm, Benjamin Guikema, Julia Meade","doi":"10.1007/s40122-026-00837-8","DOIUrl":"https://doi.org/10.1007/s40122-026-00837-8","url":null,"abstract":"<p><strong>Introduction: </strong>Neurofibromatosis type 1 (NF1) is a heterogeneous, multisystem genetic condition associated with diverse clinical manifestations, including nerve sheath tumors called plexiform neurofibroma (PN), which can be extremely painful. Both chronic pain and regular pain medication use are associated with low overall quality of life in pediatric patients with NF1-PN. Previous short-term, real-world data demonstrate that selumetinib treatment reduces prescription pain medication utilization; however, there are no published long-term real-world data.</p><p><strong>Methods: </strong>This was a retrospective analysis of pediatric and young adult patients receiving selumetinib. Patients receiving selumetinib were investigated using a US retrospective claims database and were identified with relevant national drug codes. Patients were followed from selumetinib initiation to the end of available follow-up data (≤ 3 years). Patients had ≥ 3 selumetinib prescriptions filled, were aged 2-21 years at selumetinib initiation, and had ≥ 12 months (pre- and post-selumetinib initiation) of continuous enrollment and medical/pharmacy claims activity. Patients receiving selumetinib were indexed at the time of selumetinib initiation (April 1, 2020-January 31, 2025).</p><p><strong>Results: </strong>The primary cohort comprised 220 patients (female patients: 46%; male patients: 54%), 24% of whom were receiving prescription pain medication at baseline of selumetinib initiation. At 3 years post-selumetinib initiation, this decreased to 9%. At baseline, 26/220 (12%) of patients were receiving gabapentin, half of whom discontinued gabapentin during the first year post-selumetinib initiation. At baseline, 17/220 (8%) patients were receiving oxycodone; 14/17 (82%) patients discontinued oxycodone in the first year post-selumetinib initiation. There was a 20.3% reduction in prescription pain medication utilization per year for patients receiving selumetinib (odds ratio = 0.797; p = 0.039).</p><p><strong>Conclusion: </strong>Selumetinib treatment was associated with a significant, consistent, and durable decline in prescription pain medication utilization over 3 years. Patients who continued taking pain medications experienced nominal dose reductions, and patients who received selumetinib continuously experienced a decrease in prescription pain medication utilization.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Reductions in Headache Frequency, Severity, and Disability with Eptinezumab in Adults with Chronic Migraine: Results from the PREVAIL Trial.","authors":"Amaal J Starling, David Kudrow, Neha Kapur, Susanne F Awad, S Wald Grossman, Foram Patel, Jessica Ailani, Andrew Blumenfeld, Richard B Lipton","doi":"10.1007/s40122-026-00831-0","DOIUrl":"https://doi.org/10.1007/s40122-026-00831-0","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with chronic migraine (CM) experience substantial headache-related disability. Post hoc analyses from the PREVAIL trial assessed the long-term impact of eptinezumab preventive treatment for CM on patient-centered measures of headache frequency, headache pain severity, disability, and quality of life.</p><p><strong>Methods: </strong>In the 104-week, open-label PREVAIL trial, which evaluated long-term safety and patient-reported outcomes, participants received eptinezumab 300 mg intravenously every 12 weeks to week 84 for preventive treatment of CM. The Migraine Disability Assessment (MIDAS) scale was used to evaluate proportions of participants with sustained ≥ 50% and ≥ 75% reductions in mean monthly headache days (MHDs) through 12-week dosing intervals to week 84 and changes in mean MHD frequency category (e.g., 0, 1- < 4 MHDs), Frequency-Severity Index (FSI) scores (composite of MIDAS-derived mean MHDs and headache pain severity), and days with headache-related disability through week 104.</p><p><strong>Results: </strong>Over half of participants with ≥ 50% or ≥ 75% reduction in mean MHDs after the first eptinezumab dose (weeks 1-12: 78% and 54%, respectively) or second dose (weeks 13-24: 83% and 69%, respectively) experienced sustained reductions in headache frequency through all subsequent dosing intervals until the last dose (week 84). At baseline, participants reported a mean (standard deviation [SD]) of 15.8 (7.6) MHDs. More than 60% of participants reported < 4 mean MHDs at week 12 and at all subsequent assessments through week 104 (20 weeks after last infusion) after initiating eptinezumab; 23% reported 0 mean MHDs by week 104. The mean FSI score decreased from baseline (11.4) to week 12 (3.5), with decreases maintained through week 104. Monthly days with headache-related impact also decreased from baseline to week 12, with improvements maintained through week 104.</p><p><strong>Conclusions: </strong>Treatment with eptinezumab 300 mg is associated with substantial early and long-term reductions in headache frequency, severity, and disability, indicating its ability to improve multiple aspects of the broader burden of CM. Graphical abstract available for this article.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02985398.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}