Therapeutic Advances in Chronic Disease最新文献

{"title":"Comparison of rivaroxaban-based dual antithrombotic and antiplatelet therapies for symptomatic patients with lower-extremity peripheral artery disease post-revascularization: a retrospective cohort study.","authors":"Ye Ji, Baoyan Wang, Guangyan Wu, Yepeng Zhang, Qing Wang, Min Zhou","doi":"10.1177/20406223231213262","DOIUrl":"10.1177/20406223231213262","url":null,"abstract":"<p><strong>Background: </strong>Patients with symptomatic lower-extremity peripheral artery disease (LE-PAD) are prone to serious cardiovascular and limb events. Few studies have evaluated the effect of rivaroxaban-based dual antithrombotic therapy in high-risk patients with LE-PAD in Asian populations.</p><p><strong>Objectives: </strong>To investigate the efficacy and safety of rivaroxaban-based dual antithrombotic therapy in symptomatic patients with LE-PAD.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>This study included patients with LE-PAD treated at the Nanjing Drum Tower Hospital from 1 January 2018 to 31 December 2021. These participants were divided into antiplatelet (APT) or antiplatelet therapy combined with rivaroxaban (RAPT) groups. The efficacy outcomes in this study were the occurrence of major adverse cardiovascular events (MACE), including myocardial infarction, ischemic stroke, or death from cardiovascular causes, and major adverse limb events (MALE), including urgent revascularization, acute limb ischemia, and major amputation. The safety outcomes included major and clinically relevant non-major (CRNM) bleeding. Patients were followed up until the time of death or the end of the study (31 March 2023).</p><p><strong>Results: </strong>We included 1144 patients with LE-PAD (APT: 502 patients; RAPT: 642 patients). The RAPT group had a lower risk of primary composite efficacy outcomes [hazard ratio (HR): 0.40] and a nonsignificant increase in major bleeding risk (HR: 2.33) than the APT group. The RATP group also had a significantly lower risk of secondary efficacy outcomes, including ischemic stroke (HR: 0.41), myocardial infarction (HR: 0.31), cardiovascular death (HR: 0.40), and MALE (HR: 0.65), than the APT group. The CRNM bleeding incidence varied between the two groups (HR: 3.96). Moreover, no significant interactions were observed between the subgroups and treatment groups in the composite efficacy analysis.</p><p><strong>Conclusion: </strong>Rivaroxaban-based dual antithrombotic therapy significantly reduced the occurrence of MACE in patients with LE-PAD without increasing major bleeding events. High-risk patients benefited from the dual antithrombotic therapy.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231213262"},"PeriodicalIF":3.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential application of Klotho as a prognostic biomarker for patients with diabetic kidney disease: a meta-analysis of clinical studies.","authors":"Li Xia Yu, Min Yue Sha, Yue Chen, Fang Tan, Xi Liu, Shasha Li, Qi-Feng Liu","doi":"10.1177/20406223231213246","DOIUrl":"10.1177/20406223231213246","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) is a serious diabetic complication and the performance of serum Klotho in DKD's prognostic evaluation is controversial.</p><p><strong>Objective: </strong>To assess the association of serum Klotho with adverse kidney and non-kidney clinical outcomes in patients with DKD.</p><p><strong>Design: </strong>Clinical studies regarding the relationship of serum Klotho with DKD were included. Study quality was assessed using the Newcastle-Ottawa scale. Subgroup and sensitive analyses were performed to search for the source of heterogeneity.</p><p><strong>Data sources and methods: </strong>We comprehensively searched PubMed, Embase, Web of Science, and Cochrane library databases up to 27 September 2022. The associations of Klotho with albuminuria, such as the urinary albumin creatinine ratio (UACR), kidney outcomes such as persistent albuminuria, estimated glomerular filtration rate decline, and non-kidney outcomes such as diabetic retinopathy, cardiovascular morbidity, and mortality, were evaluated. The indicators, such as the correlation coefficient (<i>r</i>), odds ratio (OR), relative risk, and hazard ratio, were retrieved or calculated from the eligible studies.</p><p><strong>Results: </strong>In all, 17 studies involving 5682 participants fulfilled the inclusion criteria and were included in this meta-analysis. There was no significant association of serum Klotho with UACR in DKD patients [summary <i>r</i>, -0.28 (-0.55, 0.04)] with high heterogeneity. By contrast, a strong association was observed regarding serum Klotho with kidney outcomes [pooled OR, 1.60 (1.15, 2.23)], non-kidney outcomes [pooled OR, 2.78 (2.11, 3.66)], or combined kidney and non-kidney outcomes [pooled OR, 1.96 (1.45, 2.65)] with moderate heterogeneity. Subgroup analysis indicated that age, study design, and the estimated glomerular filtration rate may be the sources of heterogeneity.</p><p><strong>Conclusion: </strong>A decreased serum Klotho level is possibly associated with an increased risk of developing kidney and non-kidney clinical outcomes in DKD patients; thus, Klotho may be a possible biomarker to predict DKD clinical outcomes. Additional studies are needed to clarify and validate Klotho's prognostic value.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231213246"},"PeriodicalIF":3.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispecific T cell engagers targeting CD20/CD3 in B-cell lymphoma: latest updates from 2023 EHA annual meeting.","authors":"Shenhe Jin, Yi Liu, Ye Zhang, Fengping Zhou, Liangshun You, Jin Zhang","doi":"10.1177/20406223231215701","DOIUrl":"https://doi.org/10.1177/20406223231215701","url":null,"abstract":"BiTE, has recently been approved in Europe for relapsed or refractory follicular lymphoma (R/R FL) treatment in adults who have received at least two prior systemic therapies. In a pivotal phase II study, 4 49 of 90 (54%) enrolled patients achieved CR at the end of treatment, with a 24-month PFS of 77%.","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231215701"},"PeriodicalIF":3.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based fundus image analysis for cardiovascular disease: a review.","authors":"Symon Chikumba, Yuqian Hu, Jing Luo","doi":"10.1177/20406223231209895","DOIUrl":"https://doi.org/10.1177/20406223231209895","url":null,"abstract":"<p><p>It is well established that the retina provides insights beyond the eye. Through observation of retinal microvascular changes, studies have shown that the retina contains information related to cardiovascular disease. Despite the tremendous efforts toward reducing the effects of cardiovascular diseases, they remain a global challenge and a significant public health concern. Conventionally, predicting the risk of cardiovascular disease involves the assessment of preclinical features, risk factors, or biomarkers. However, they are associated with cost implications, and tests to acquire predictive parameters are invasive. Artificial intelligence systems, particularly deep learning (DL) methods applied to fundus images have been generating significant interest as an adjunct assessment tool with the potential of enhancing efforts to prevent cardiovascular disease mortality. Risk factors such as age, gender, smoking status, hypertension, and diabetes can be predicted from fundus images using DL applications with comparable performance to human beings. A clinical change to incorporate DL systems for the analysis of fundus images as an equally good test over more expensive and invasive procedures may require conducting prospective clinical trials to mitigate all the possible ethical challenges and medicolegal implications. This review presents current evidence regarding the use of DL applications on fundus images to predict cardiovascular disease.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231209895"},"PeriodicalIF":3.5,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispecific antibody treatment of multiple myeloma: latest updates from the 2022 ASH annual meeting.","authors":"Xuejiao Yin, Yi Liu, Jianai Sun, Hongyan Tong, Haitao Meng, Liangshun You","doi":"10.1177/20406223231213251","DOIUrl":"https://doi.org/10.1177/20406223231213251","url":null,"abstract":"<p><strong>Background: </strong>Effective novel therapies for multiple myeloma (MM) patients who are unresponsive to conventional treatments (triple-class refractory) are an urgent need. Bispecific antibodies (BsAbs) offer a promising new approach to stimulate T cells and induce tumor cell death by targeting molecules on the surface of malignant plasma cells and CD3 on the surface of T cells.</p><p><strong>Objectives: </strong>Addressing the issue of improving the prognosis of triple-class refractory MM patients has become a significant clinical challenge.</p><p><strong>Design: </strong>This is a brief report.</p><p><strong>Methods: </strong>This article summarizes the latest updates of BsAbs treatment of MM from the 2022 ASH annual meeting.</p><p><strong>Results: </strong>BsAbs that target B-cell maturation antigen and G protein-coupled receptor family C group 5 memberD have demonstrated remarkable clinical activity and favorable safety profiles. Many potential targets for myeloma cells are currently undergoing phase I/II clinical trials, and these off-the-shelf bispecific molecules are likely to become a critical part of the MM treatment landscape.</p><p><strong>Conclusion: </strong>This article provides an overview of the latest advances in BsAbs immunotherapy for refractory and relapsed MM and highlights significant findings from the 2022 ASH annual meeting.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231213251"},"PeriodicalIF":3.5,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emerging role of digital health in the management of asthma.","authors":"Alan Kaplan, Michael Boivin, Jacques Bouchard, James Kim, Sean Hayes, Christopher Licskai","doi":"10.1177/20406223231209329","DOIUrl":"https://doi.org/10.1177/20406223231209329","url":null,"abstract":"<p><p>The most common reasons seen for lack of asthma control include misconceptions about disease control, low controller treatment adherence, poor inhaler technique, and the resulting underuse of controllers and overuse of short-acting beta2 agonists (SABAs). Narrowing these care gaps may be achieved through well-designed patient education that considers the patient's motivation, beliefs, and capabilities regarding their asthma and its management and empowers the patient to become an active participant in treatment decisions. Digital health technologies (DHTs) and digital therapeutic (DT) devices provide new opportunities to monitor treatment behaviors, improve communication between healthcare providers and patients, and generate data that inform educational interactions. DHT and DT have been proven effective in enhancing patient self-management in other chronic conditions, particularly diabetes. Accelerated integration of DHT and DT into the management of asthma patients is facilitated by the use of digital inhalers that employ sensor technology (\"smart\" inhalers). These devices efficiently provide real-time feedback on controller adherence, SABA use, and inhaler technique that have the strong potential to optimize asthma control.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231209329"},"PeriodicalIF":3.5,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spleen stiffness determined by spleen-dedicated device accurately predicted esophageal varices in cirrhosis patients.","authors":"Jiqing Liu,&nbsp;Hangfei Xu,&nbsp;Weiyuan Liu,&nbsp;Hongmei Zu,&nbsp;Huiguo Ding,&nbsp;Fankun Meng,&nbsp;Jing Zhang","doi":"10.1177/20406223231206223","DOIUrl":"https://doi.org/10.1177/20406223231206223","url":null,"abstract":"<p><strong>Background: </strong>The advantages of spleen stiffness in prediction of high-risk varices (HRV) in cirrhosis patients have been confirmed. Recently, a new device utilizing a 100 Hz probe dedicated to spleen stiffness measurement (SSM) was developed.</p><p><strong>Objectives: </strong>To validate the clinical applicability of SSM@100 Hz in predicting HRV by comparing it with other non-invasive tests (NITs).</p><p><strong>Design: </strong>A prospective cohort study.</p><p><strong>Methods: </strong>A total of 171 cirrhosis patients who underwent esophagogastroduodenoscopy (EGD) examination were included in this study. SSM using a 100 Hz probe and liver stiffness measurement using a 50 Hz probe were performed. Additionally, 22 healthy controls underwent spleen stiffness evaluation using the 100 Hz probe.</p><p><strong>Results: </strong>The failure rates of spleen stiffness examination in patients with cirrhosis and in healthy controls were 2.9% and 4.5%, respectively. The means of SSM values were 56.4 ± 21.6 and 13.8 ± 6.7 kPa in cirrhosis and controls. SSM increased proportionally with the severity of esophageal varices. The area under receiver operating characteristic (ROC) for spleen stiffness in predicting HRV was 0.881 (95% confidence interval 0.829-0.934), with a cutoff value of 43.4 kPa. The accuracy, false negative rate and EGD spare rate were 86.5%, 2.5% and 24.3%, respectively. For HRV prediction, SSM was comparable to expanded Baveno VI and VII and superior to other NITs. As to viral <i>versus</i> non-viral cirrhosis and compensated <i>versus</i> decompensated cirrhosis, the cut-off and performance of SSM were different.</p><p><strong>Conclusion: </strong>SSM@100 Hz demonstrates high accuracy in predicting HRV with a low missed HRV rate. Our findings suggest that SSM@100 Hz can be used independently due to its simplicity and effectiveness. However, further studies are needed to determine appropriate cutoff values based on the cause of cirrhosis and liver function.</p><p><strong>Trail registration: </strong>ChiCTR2300070270.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231206223"},"PeriodicalIF":3.5,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyoderma gangrenosum in ulcerative colitis patient treated with vedolizumab: adsorptive granulocyte/monocyte apheresis as a new therapeutic option refractory cases - a case report and literature review.","authors":"Mauro Mastronardi,&nbsp;Elisabetta Cavalcanti,&nbsp;Nunzia Labarile,&nbsp;Raffaele Armentano,&nbsp;Francesco Gabriele,&nbsp;Margherita Curlo","doi":"10.1177/20406223231194190","DOIUrl":"https://doi.org/10.1177/20406223231194190","url":null,"abstract":"<p><p>Extraintestinal manifestations occur rather frequently in ulcerative colitis (UC) and Crohn's disease patients and are usually related to an exacerbation of the underlying intestinal bowel disease but sometimes may run a course independent of the inflammatory bowel diseases (IBD). About one-third of patients with IBD develop extraintestinal manifestations, such as pyoderma gangrenosum (PG). PG is an uncommon inflammatory skin disorder of unknown pathogenesis. There are no specific serological or histological markers, and diagnosis is predominantly clinical. Topical and systemic therapies are both vital aspects of treatment and immune modulators have been used with increasing success in recent years, although immunosuppressive drugs raise some concerns due to an increased risk of serious and opportunistic infections and cancer, particularly in elderly and comorbid patients, underlining the unmet need for safer alternative therapies. Thus, in this case report, we highlighted an adsorptive granulocyte/monocyte apheresis (GMA) as a new therapeutic possibility in IBD patients with extraintestinal manifestations. We report a case of a 60-year woman with a history of UC with a Mayo grade 3 score which was associated with a PG. Given that the patients maintained clinical remission with vedolizumab, we preferred not to perform a combined treatment with other antitumor necrosis factor-alpha or ciclosporin, thus avoiding an increased risk of serious infections in the patient. Therefore, we performed the extracorporeal leukocyte apheresis. The patient progressed favorably, with progressive improvement of skin and bowel disease. Therefore, adsorptive GMA has a very favorable safety profile and has been confirmed in numerous studies. In this study, we underlined that an intensive regimen of GMA paves the way to an ideal option for patients with severe and refractory PG complicated with UC.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231194190"},"PeriodicalIF":3.5,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative short-term risks of infection and serious infection in patients receiving biologic and small-molecule therapies for psoriasis and psoriatic arthritis: a systemic review and network meta-analysis of randomized controlled trials.","authors":"Hsien-Yi Chiu,&nbsp;Yi-Teng Hung,&nbsp;Yu-Huei Huang","doi":"10.1177/20406223231206225","DOIUrl":"https://doi.org/10.1177/20406223231206225","url":null,"abstract":"<p><strong>Background: </strong>Infection events are a major concern for patients and physicians when making psoriasis treatment decisions.</p><p><strong>Objective: </strong>To estimate the relative short-term risks of infection and serious infection for biologic and small molecule therapies in the treatment of moderate-to-severe plaque psoriasis (PsO) and psoriatic arthritis (PsA).</p><p><strong>Data sources and methods: </strong>A systematic literature search of the PubMed, EMBASE, and Web of Science databases was conducted on 17 June 2022. We included phase II, III, or IV randomized controlled trials (RCTs) of biologic and small-molecule therapies that are licensed or likely to gain approval soon for PsO and PsA, as well as infection data reports. Two investigators independently extracted the data based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Network meta-analysis (NMA) was performed to estimate the pooled relative risks (RRs) and corresponding 95% confidence intervals of total infections and serious infections for treatments during placebo-controlled phases of RCTs. The surface under the cumulative ranking area (SUCRA) was calculated to rank the infection risk for each treatment.</p><p><strong>Results: </strong>A total of 94 RCTs with a total of 19 treatment arms involving 54,369 participants were analyzed. For patients with PsO, bimekizumab, secukizumab, risankizumab, ustekinumab, apremilast, guselkumab, and adalimumab were associated with significantly higher risks of infection than placebo; SUCRA ranked infliximab, deucravacitinib, and bimekizumab with the highest risks of infection. For patients with PsA, bimekizumab, apremilast, and upadacitinib (30 mg daily) were associated with higher risks of infection; SUCRA ranked bimekizumab with the highest risk of infection. No treatments, except for upadacitinib (30 mg daily), were associated with a higher risk of serious infection than placebo in PsA.</p><p><strong>Conclusion: </strong>This NMA provides a comprehensive assessment of the comparative short-term risks of infection, which could help physicians and patients to select individualized treatments for psoriasis.</p><p><strong>Registration: </strong>CRD42022359873.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231206225"},"PeriodicalIF":3.5,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report.","authors":"Qiao Wang,&nbsp;Rui Han,&nbsp;Rong Hu,&nbsp;Qianxi Liu,&nbsp;Dong Huang,&nbsp;Haocheng Zhou","doi":"10.1177/20406223231206224","DOIUrl":"https://doi.org/10.1177/20406223231206224","url":null,"abstract":"<p><p>Sensitization of dorsal horn ganglion sensory neuron plays a crucial role in the maintenance of chronic pain disorder. Multiple interventions targeting dorsal horn ganglion can provide considerable relief of pain, including selective nerve root block, pulsed radiofrequency, and electrical nerve stimulation technique. It remains controversial about the superiority of neuromodulation mentioned above due to distinct pattern of analgesic mechanism. Here, we reported one 71-year-old male presenting at our pain clinic with severe, unilateral lower limb pain caused by postherpetic neuralgia. An implantable stimulator with dual neuromodulation mode, combining pulsed radiofrequency with electrical nerve stimulation, was then placed into the lateral epidural space adjacent to dorsal root ganglion at L4 level. Standard stimulation programing was performed with technicians to achieve satisfactory control of pain, with numerical rating scale decreasing from 8 to 2 postoperatively. This novel dual function neuromodulation strategy may provide an alternative option for pain management for those with intractable neuropathic pain.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231206224"},"PeriodicalIF":3.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/cd/10.1177_20406223231206224.PMC10580718.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49682583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}