Pain and Therapy最新文献

{"title":"Efficacy of Rebox Electrotherapy in Pain Management: A Randomized Double-Blind Sham-Controlled Crossover Trial.","authors":"Igor Martuliak, Ľuboš Chvála, Miroslav Ferenčík, Vratislav Fabián, Matěj Slovák","doi":"10.1007/s40122-025-00768-w","DOIUrl":"https://doi.org/10.1007/s40122-025-00768-w","url":null,"abstract":"<p><strong>Introduction: </strong>Rebox therapy is a form of noninvasive transcutaneous electrotherapy, which delivers microcurrent kilohertz-frequency pulses in multiple points over the target area. Despite decades of use in pain management, clinical evidence supporting Rebox remains inconclusive, with a lack of rigorous sham-controlled trials. This study aimed to evaluate its analgesic effect in a single-center, randomized, double-blind, sham-controlled crossover trial.</p><p><strong>Methods: </strong>The study included consecutive patients with non-cancer nociceptive pain with average pain intensity ≥ 4 on a numerical rating scale (NRS), and pain duration of 2-12 weeks (de novo or acutely exacerbated chronic pain). Patients were randomized (1:1) into two arms based on the sequence of stimulation periods. Each period consisted of eight sessions of either Rebox or sham treatment, administered every other working day, with a 1-week washout period. The primary outcome was the difference in the reduction of pain intensity (average and worst pain in the last 24 h) following active versus sham stimulation.</p><p><strong>Results: </strong>Seventy-one patients completed the study, with musculoskeletal back pain being the most common indication (n = 60). Compared to the sham, Rebox significantly reduced both average pain (NRS difference: 2.2, 95% CI 0.8-3.6, Cohen's d = 0.75, p = 0.002) and worst pain (NRS difference: 2.3, 95% CI 1.2-3.5, Cohen's d = 0.91, p < 0.001). A significant placebo analgesic effect was observed only in the sham-first arm. The treatment was well tolerated, with only minor and transient side effects.</p><p><strong>Conclusion: </strong>Rebox demonstrated a significant analgesic effect compared to the sham. The treatment was safe and well tolerated. These findings support integrating Rebox into clinical pain management, warranting further investigation in larger trials.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964483","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":"Cost-Effectiveness of a High-Concentration (179 mg) Capsaicin Patch for the Treatment of Patients with Peripheral Neuropathic Pain in Scotland.","authors":"Rita Freitas, Marjolijn van Keep, Prashanth Kandaswamy, Anja Prüfert, Miranda Ager, Marielle Eerdekens","doi":"10.1007/s40122-025-00769-9","DOIUrl":"https://doi.org/10.1007/s40122-025-00769-9","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral neuropathic pain (PNP) is a chronic condition often inadequately controlled by oral pharmacologic treatments. High-concentration capsaicin patch (HCCP) is a topical neurolytic treatment for PNP. This study assessed the cost-effectiveness of HCCP as an add-on to standard of care (SoC) in patients with PNP in Scotland.</p><p><strong>Methods: </strong>A cost-utility analysis was conducted using a Markov model with 3-month cycles and a lifetime horizon to determine the cost-effectiveness of HCCP added-on to SoC compared to SoC alone, in adult patients with PNP. The model included five health states (no pain, mild, moderate, severe pain, and death) and was developed according to Scottish Medicines Consortium (SMC) guidance from a National Health Service (NHS) Scotland perspective. Clinical inputs were derived from HCCP trials (e.g., PACE), and health-related quality of life was based on EQ-5D values from HCCP trials. Analyses were conducted for an adult PNP population, and diabetic and non-diabetic etiologies. Costs included drug acquisition, administration, drug and disease monitoring, adverse events, and-in a scenario analysis-societal costs.</p><p><strong>Results: </strong>For the adult PNP population, HCCP + SoC resulted in an incremental gain of 1.00 quality-adjusted life-years (QALYs) at an additional cost of £13,479, yielding an incremental cost-effectiveness ratio (ICER) of £13,516 per QALY. ICERs for specific etiologies were £11,383 for non-diabetic and £16,442 for diabetic PNP populations. Deterministic and probabilistic sensitivity analyses (PSA) confirmed robustness of the model, with 89% of PSA iterations falling below a £20,000/QALY threshold. Scenario analysis using a societal perspective further improved cost-effectiveness (ICER: £7475).</p><p><strong>Conclusions: </strong>HCCP is a cost-effective add-on therapy for the treatment of adults with PNP in Scotland, with consistent findings across diabetic and non-diabetic populations. These results support the benefits of integrating HCCP in healthcare systems and clinical practice, both in terms of patient outcomes and economic benefits for the system.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964262","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 Repetitive Transcranial Magnetic Stimulation on the Symptoms and Brain Imaging in Patients with Fibromyalgia Syndrome: A Randomized Controlled Pilot Trial.","authors":"Laura Ackermann, Daniel Zeller, Thorsten Odorfer, György A Homola, Thomas Kampf, Mirko Pham, Hans-Christoph Aster, Claudia Sommer","doi":"10.1007/s40122-025-00770-2","DOIUrl":"https://doi.org/10.1007/s40122-025-00770-2","url":null,"abstract":"<p><strong>Introduction: </strong>Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) has been shown to reduce the symptoms of patients with fibromyalgia syndrome (FMS). We tested whether rTMS of the left DLPFC can reduce the main symptoms in FMS and whether TMS induces changes in brain functional and structural connectivity, cortical gray matter volume, and the metabolites/neurotransmitters GABA and combined glutamate/glutamine (Glx).</p><p><strong>Methods: </strong>Twenty-seven women diagnosed with FMS according to the 2010 ACR criteria were included in a randomized controlled trial. They received either ten sessions of active or sham 10-Hz stimulation over 2 weeks embedded in a longitudinal neuroimaging setup, including one pre-treatment (T1), one post-treatment (T2), and one follow-up (T3) 3 T MRI scan. Pain and pain catastrophizing, depression, daily life/quality of life, and anxiety were assessed using standard questionnaires.</p><p><strong>Results: </strong>Linear mixed-model analysis of clinical data showed a significant main effect of the main factor time but did not reveal group differences or group-time interactions, indicating a large placebo effect with symptom reduction in both groups. Fractional anisotropy (FA) values of the pontine crossing tract, the sagittal stratum, and the right cingulum in the active rTMS group increased between pre-TMS and the follow-up time points. Subgroup analysis of responders of the treatment group revealed higher functional connectivity between the left DLPFC and the right cerebellum. We did not find evidence for changes in the treatment group in the gray matter of the left DLPFC and for the concentrations of GABA and Glx, but a trend towards decreasing Glx levels for the factor time in all patients could be detected.</p><p><strong>Conclusions: </strong>While these results may be due to small sample size and short treatment duration, the findings of increased FA after active rTMS and higher functional connectivity between DLPFC and cerebellum in responders should be further explored.</p><p><strong>Trial registration: </strong>Auswirkungen der nicht-invasiven Neuromodulation auf das Gehirn bei Fibromyalgiepatienten.</p><p><strong>Drks-id: </strong>DRKS00019051.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964516","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 Pharmacological Treatment Pattern of Neuropathic Pain in China: A Retrospective, Database, Multicenter Study (ReTARdant) Protocol.","authors":"Qi Pan, Xiaoyu Zhai, Haining Wang, Jianling Du, Yanxia Shi, Xuefeng Yu, Sunjie Yan, Xiaohong Wu, Hui-Hui Li, Tao Sun, Lixin Guo, Jun Zhao, Bifa Fan","doi":"10.1007/s40122-025-00767-x","DOIUrl":"https://doi.org/10.1007/s40122-025-00767-x","url":null,"abstract":"<p><strong>Introduction: </strong>Neuropathic pain (NP), including diabetic peripheral neuropathic pain (DPNP) and chemotherapy-induced peripheral neuropathy (CIPN) as common subtypes, imposes a significant clinical burden on patients, severely affecting their quality of life. The real-world evidence on demographic characteristics, treatment patterns, and adherence data of DPNP and CIPN is still limited.</p><p><strong>Methods: </strong>A multicenter, retrospective, observational study using electronic medical record (EMR) systems involving approximately 600 patients with DPNP and 400 with CIPN from nine hospitals was planned. The study period extended from January 1, 2017 to December 31, 2022, which includes the enrollment period, pre-enrollment period, and observation period. Included patients will be adult (aged ≥ 18 years) diagnosed with DPNP or CIPN and receiving at least one index regimen, with index date defined as the initiation date of index regimen. At least one medical record within 12 months after index date will also be required for inclusion. The observation period is defined as the period from the index date to the end of the study data collection for at least 12 months.</p><p><strong>Planned outcomes: </strong>The primary objective is to describe the demographics, clinical characteristics, and treatment patterns, including types and proportion of treatment regimens, treatment discontinuation/switching/add-on, restarting after discontinuation, duration of index regimen, and time to treatment add-on. The secondary and exploratory measures include the dosing pattern and real-world adherence of regimens.</p><p><strong>Trial registration: </strong>NCT06546202 (ClinicalTrials.gov).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817326","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":"Adherence to CONSORT-PRO Extension Guidelines for Patient-Reported Outcomes in Randomized Controlled Trials Focused on Peripheral Nerve Blocks: A Meta-epidemiological Study.","authors":"Adam Khan, Tiffany Nguyen, Bryan Dunford, Taimoor Khan, Mahnoor Khalid, Cody Hillman, Samuel Shepard, Micah Kee, Will Roberts, Ashlyn Terrell, Landon Stallings, Ryan Ottwell, Micah Hartwell, Matt Vassar","doi":"10.1007/s40122-025-00766-y","DOIUrl":"https://doi.org/10.1007/s40122-025-00766-y","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-reported outcomes (PROs), such as peri- and postoperative pain scores, capture patient perspectives in regional anesthesia trials. However, whether these outcomes are reported according to established guidelines remains unclear. The CONSORT statement and its PRO extension (CONSORT-PRO) aim to enhance transparency in reporting PROs, yet no study has investigated adherence in peripheral nerve block (PNB) trials. Our meta-epidemiological investigation evaluated how well PNB randomized controlled trials (RCTs) adhere with CONSORT-PRO and explored whether trial characteristics affect reporting quality.</p><p><strong>Methods: </strong>We performed a cross-sectional, meta-epidemiological study to determine adherence to CONSORT-PRO reporting guidelines in RCTs. We searched Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and MEDLINE for RCT publications investigating PNBs between 2006 and 2020. RCTs investigating PNBs that incorporated PROs as a primary or secondary outcome were included. All other studies, reviews, or publications without a PRO were excluded.</p><p><strong>Results: </strong>In total, 65 RCTs met the inclusion criteria. Mean CONSORT-PRO adherence was 46.80 ± 17.36%, and trials that designated a PRO as the primary endpoint were more adherent than those in which the PRO was secondary (49.27 ± 16.58% versus 38.57 ± 17.92%; P = 0.035). Trials with ≥ 6-month follow-up were 16.24% more adherent than those with ≤ 3-month follow-up (P = 0.006). Studies that used a visual analog scale (VAS) or numeric rating scale (NRS) in combination with other PRO instruments were significantly more adherent than trials using VAS alone (P = 0.028).</p><p><strong>Conclusions: </strong>Our meta-epidemiological review reveals substantial nonadherence to CONSORT-PRO guidelines in PNB trials. Although PROs are crucial for capturing patient-centered outcomes, they remain under-reported, especially when treated as secondary endpoints. Using diverse, validated measures beyond VAS/NRS and consistently applying CONSORT-PRO can enhance the quality, transparency, and clinical relevance of future trials. Targeted education for authors, editors, and clinicians-and expanded research on neuraxial techniques-will further strengthen reporting standards and the interpretability of anesthesia evidence.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795047","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":"Liposomal Bupivacaine vs. Plain Bupivacaine with Dexamethasone for Rhomboid Intercostal Block in the Management of Postoperative Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Non-inferiority Trial.","authors":"Lei Xie, Yazhi Xi, Xinyao He, Mingzi An, Xiaoyu Jia, Zhenping Li, Tao Chen, Qinghe Zhou","doi":"10.1007/s40122-025-00763-1","DOIUrl":"https://doi.org/10.1007/s40122-025-00763-1","url":null,"abstract":"<p><strong>Introduction: </strong>Effective and sustained postoperative analgesia is essential to enhance recovery after video-assisted thoracoscopic surgery (VATS). Liposomal bupivacaine, a multivesicular formulation enabling extended local anesthetic release, offers a mechanistic advantage over conventional agents. However, prior comparisons with adjuvant-enhanced regimens such as plain bupivacaine plus dexamethasone were confounded by pharmacological and dose inequivalence. This equivalence-dose randomized controlled trial evaluated whether liposomal bupivacaine provides non-inferior analgesia to the standard combination when administered via rhomboid intercostal block (RIB).</p><p><strong>Methods: </strong>In this double-blind randomized controlled trial, 90 VATS patients were randomly assigned to receive either: a 20-ml premixed solution containing 93 mg of liposomal bupivacaine combined with 25 mg of plain bupivacaine (liposomal bupivacaine group), or a 20-ml admixture of 105 mg of plain bupivacaine and 5 mg of dexamethasone (plain bupivacaine with dexamethasone group). The primary outcome assessed was the area under the curve (AUC) of the 48-h resting pain numeric rating scale (NRS). Secondary outcomes consisted of opioid consumption, dermatomal spread, and Quality of Recovery-15 scores (QoR-15).</p><p><strong>Results: </strong>Liposomal bupivacaine was shown to be non-inferior to plain bupivacaine with dexamethasone, with a 48-h NRS AUC of 105.5 ± 13.6 vs. 113.1 ± 16.3 (mean difference - 7.6; 95% CI - 13.9 to - 1.2, upper limit < non-inferiority margin 3.7). Opioid use and dermatomal spread were comparable within the first 24 h (P > 0.05). There was a notable contrast in sustained dermatome blockade at 48 and 72 h between the two groups (P < 0.001). The liposomal bupivacaine group demonstrated a significantly reduced opioid requirement (P = 0.016) within 24-48 h and superior QoR-15 scores on postoperative day 2 (POD2) (P < 0.001). Safety profiles were comparable, with no between-group differences in postoperative nausea and vomiting or other severe complications (P > 0.05).</p><p><strong>Conclusions: </strong>Rhomboid intercostal block with liposomal bupivacaine provided similar analgesia to plain bupivacaine with dexamethasone for postoperative pain after VATS.</p><p><strong>Trial registration: </strong>The trial was registered on ClinicalTrials.gov (NCT06392191). Graphical Abstract available in the Supplementary Materials for this article.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775947","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":"Letter to the Editor regarding \"Effects of TTP-PECS Block Under Opioid-Sparing General Anesthesia on Postoperative Analgesia and Early Recovery Quality in Patients Undergoing Modified Radical Mastectomy\".","authors":"Zhi-Bin Huang, Dan-Feng Wang, Fu-Shan Xue","doi":"10.1007/s40122-025-00743-5","DOIUrl":"10.1007/s40122-025-00743-5","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1431-1433"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Combined High-Intensity Laser Therapy and Collagenase Chemonucleolysis in Lumbar Disc Herniation Management: a Prospective Randomized Controlled Trial.","authors":"Peng Song, Chao Ma, Chenchen Xu, Yongjun Zhang, Yan Yuan","doi":"10.1007/s40122-025-00756-0","DOIUrl":"10.1007/s40122-025-00756-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Lumbar disc herniation (LDH) is a prevalent degenerative spinal disorder. While collagenase chemonucleolysis is effective in long-term LDH management, delayed symptom relief remains a limitation. Recent studies suggest that high-intensity laser therapy (HILT) may enhance tissue repair and pain modulation, providing a rationale for exploring its synergistic effects with collagenase therapy. This study aimed to investigate whether combining HILT with collagenase chemonucleolysis could accelerate early postoperative recovery in patients with lumbar disc herniation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-blind randomized controlled trial was conducted at the Department of Pain Management, The First People's Hospital of Changzhou, between October 2023 and October 2024. This single-center, single-blind randomized controlled trial finally enrolled 60 eligible patients with lumbar disc herniation; participants were randomly assigned to the experimental (HILT + collagenase) or control (collagenase alone) group using a computer-generated randomization sequence with 1:1 allocation. Group assignments were concealed in sealed opaque envelopes until intervention initiation. All participants underwent collagenase chemonucleolysis, with the control group receiving standard postoperative care combined with sham laser therapy, while the experimental group received additional high-intensity laser irradiation alongside conventional treatment. The primary endpoints comprised visual analog scale (VAS) pain scores and clinical efficacy rates evaluated using modified MacNab criteria, while secondary outcomes included the Oswestry Disability Index (ODI), straight-leg-raising angle measurements, and 36-Item Short Form Health Survey (SF-36) quality of life assessments, with standardized evaluations conducted at five predefined intervals: preoperative baseline, 1 week, 1 month, 3 months, and 6 months postoperatively. Statistical analyses were performed using SPSS 20.0. Continuous variables were compared via independent t-tests or Mann-Whitney U tests, while categorical variables were analyzed using chi-squared tests. All tests were two-tailed, with P &lt; 0.05 considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 60 patients (30 per group) with a mean age of 57.15 ± 9.18 years completed the study. Baseline characteristics including age, gender, body mass index (BMI), herniation level, and symptom duration showed no significant intergroup differences (all P &gt; 0.05). No significant baseline differences were observed between groups regarding age (58.00 ± 7.13 versus 57.06 ± 9.08 years), gender distribution (male: 53.3% versus 50.0%), or disease duration (5.17 ± 3.45 versus 5.73 ± 3.07 months) (all P &gt; 0.05). The results showed that there was no statistically significant difference in baseline data between the two groups of patients. At 1 week and 1 month postoperatively, the experimental group demonstrated signific","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1379-1398"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding Horizons of Buprenorphine: A Comprehensive Narrative Review of Its Pharmacological Properties and Clinical Applications in Chronic Pain.","authors":"Diego Fornasari, Arturo Cuomo","doi":"10.1007/s40122-025-00753-3","DOIUrl":"10.1007/s40122-025-00753-3","url":null,"abstract":"<p><p>Buprenorphine has gained significant attention for its unique pharmacological properties, making it a valuable tool in chronic pain management. Unlike traditional opioids, buprenorphine's partial and biased agonist actions at the μ-opioid receptor provide potent analgesia while minimizing risks such as respiratory depression, tolerance, and dependence. Its favorable pharmacokinetic profile provides the potential for expanding its clinical use in different patient populations. A literature search was conducted in PubMed, Web of Science, and Google Scholar to identify peer-reviewed studies on recent developments in the pharmacological features and new clinical applications of buprenorphine, including original research, reviews, and consensus statements. This comprehensive review explores the expanding clinical applications of buprenorphine, emphasizing its role in managing chronic pain in elderly patients, individuals with cardiac conditions, and those with renal impairments. Emerging evidence highlights its utility in addressing chronic pain in younger adults and its potential in mitigating side effects associated with aromatase inhibitor therapy in patients with breast cancer. Additionally, buprenorphine's lower endocrine side-effect profile and antidepressant properties open new therapeutic avenues for pain-associated depression. With its unique pharmacodynamics, transdermal formulations for sustained drug release, and reduced adverse effects, buprenorphine represents a promising option for tailored, multimodal pain management strategies, especially in populations with complex medical needs. Further studies are warranted to confirm its broad therapeutic potential.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1247-1261"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-Rich Plasma for Treating Chronic Noncancer Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Fengfeng Wang, Fei Meng, Timmy Chi Wing Chan, Stanley Sau Ching Wong","doi":"10.1007/s40122-025-00751-5","DOIUrl":"10.1007/s40122-025-00751-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Chronic noncancer pain represents a significant global health challenge, contributing to disability, lost productivity, diminished quality of life, and substantial socioeconomic burden. Platelet-rich plasma (PRP) has emerged as a promising therapeutic option for managing chronic pain. However, a comprehensive assessment of its efficacy and the evidence supporting its use remains limited. This study aimed to systematically evaluate the analgesic effectiveness of PRP compared with placebo or active drug treatments across a wide range of chronic noncancer pain conditions using a rigorous meta-analytic approach. The goal is to provide evidence-based insights to inform clinical decision-making and improve patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted in the PubMed, Embase, MEDLINE, and Cochrane Library databases to identify randomized controlled trials (RCTs). Studies were screened according to predefined inclusion and exclusion criteria. A random-effects model was applied to account for heterogeneity among studies. The primary outcome, pain scores in patients with chronic noncancer pain, was assessed using the standardized mean difference (SMD). The risk of bias of the included studies was evaluated using the Revised Cochrane Risk-of-Bias Tool (RoB 2). The quality of evidence was rated by the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 691 RCTs were screened, and 56 studies (comprising 103 comparisons and 7142 patients) were eligible for analysis. PRP was associated with a statistically significant reduction in pain scores compared with both active drug treatments and placebo (SMD = -0.37, 95% confidence interval (CI) -0.59 to -0.15, p = 0.001). No significant differences were observed in pain scores for follow-up periods shorter than 3 months (SMD = 0.12, 95% CI -0.16 to 0.40, p &gt; 0.05). A statistically significant and moderate reduction in pain score was found for follow-up durations of at least 3 months (SMD = -0.69, 95% CI -0.98 to -0.40, p &lt; 0.001). Meta-analyses of subgroups revealed statistically significant and moderate pain reduction in favor of PRP versus active drug treatments for osteoarthritic knee pain (SMD = -0.59, 95% CI -1.01 to -0.17, p = 0.009) and rotator cuff tendinopathy/tear (SMD = -0.60, 95% CI -1.01 to -0.19, p = 0.01), but no significant differences for plantar fasciitis (SMD = 0.03, 95% CI -0.98 to 1.04, p &gt; 0.05). PRP was associated with moderate pain reduction when compared with corticosteroid (SMD = -0.53, 95% CI -0.98 to -0.08, p = 0.02) and hyaluronic acid injection (SMD = -0.55, 95% CI -0.89 to -0.21, p = 0.004).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PRP injections appear to effectively reduce pain in various chronic noncancer pain conditions and show sup","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1169-1188"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}