Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.

<h4>Background</h4>A major problem in pain medicine is the lack of knowledge about which treatment suits a specific patient. We tested the ability of quantitative sensory testing to predict the analgesic effect of pregabalin and placebo in patients with chronic pancreatitis.<h4>Met...

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Autores principales:	Søren S Olesen, Carina Graversen, Stefan A W Bouwense, Harry van Goor, Oliver H G Wilder-Smith, Asbjørn M Drewes
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ae8fcf81ac2a42dc8f3f2fdcf11460f5
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spelling	oai:doaj.org-article:ae8fcf81ac2a42dc8f3f2fdcf11460f52021-11-18T07:55:11ZQuantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.1932-620310.1371/journal.pone.0057963https://doaj.org/article/ae8fcf81ac2a42dc8f3f2fdcf11460f52013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23469256/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>A major problem in pain medicine is the lack of knowledge about which treatment suits a specific patient. We tested the ability of quantitative sensory testing to predict the analgesic effect of pregabalin and placebo in patients with chronic pancreatitis.<h4>Methods</h4>Sixty-four patients with painful chronic pancreatitis received pregabalin (150-300 mg BID) or matching placebo for three consecutive weeks. Analgesic effect was documented in a pain diary based on a visual analogue scale. Responders were defined as patients with a reduction in clinical pain score of 30% or more after three weeks of study treatment compared to baseline recordings. Prior to study medication, pain thresholds to electric skin and pressure stimulation were measured in dermatomes T10 (pancreatic area) and C5 (control area). To eliminate inter-subject differences in absolute pain thresholds an index of sensitivity between stimulation areas was determined (ratio of pain detection thresholds in pancreatic versus control area, ePDT ratio). Pain modulation was recorded by a conditioned pain modulation paradigm. A support vector machine was used to screen sensory parameters for their predictive power of pregabalin efficacy.<h4>Results</h4>The pregabalin responders group was hypersensitive to electric tetanic stimulation of the pancreatic area (ePDT ratio 1.2 (0.9-1.3)) compared to non-responders group (ePDT ratio: 1.6 (1.5-2.0)) (P = 0.001). The electrical pain detection ratio was predictive for pregabalin effect with a classification accuracy of 83.9% (P = 0.007). The corresponding sensitivity was 87.5% and specificity was 80.0%. No other parameters were predictive of pregabalin or placebo efficacy.<h4>Conclusions</h4>The present study provides first evidence that quantitative sensory testing predicts the analgesic effect of pregabalin in patients with painful chronic pancreatitis. The method can be used to tailor pain medication based on patient's individual sensory profile and thus comprises a significant step towards personalized pain medicine.Søren S OlesenCarina GraversenStefan A W BouwenseHarry van GoorOliver H G Wilder-SmithAsbjørn M DrewesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e57963 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Søren S Olesen Carina Graversen Stefan A W Bouwense Harry van Goor Oliver H G Wilder-Smith Asbjørn M Drewes Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
description	<h4>Background</h4>A major problem in pain medicine is the lack of knowledge about which treatment suits a specific patient. We tested the ability of quantitative sensory testing to predict the analgesic effect of pregabalin and placebo in patients with chronic pancreatitis.<h4>Methods</h4>Sixty-four patients with painful chronic pancreatitis received pregabalin (150-300 mg BID) or matching placebo for three consecutive weeks. Analgesic effect was documented in a pain diary based on a visual analogue scale. Responders were defined as patients with a reduction in clinical pain score of 30% or more after three weeks of study treatment compared to baseline recordings. Prior to study medication, pain thresholds to electric skin and pressure stimulation were measured in dermatomes T10 (pancreatic area) and C5 (control area). To eliminate inter-subject differences in absolute pain thresholds an index of sensitivity between stimulation areas was determined (ratio of pain detection thresholds in pancreatic versus control area, ePDT ratio). Pain modulation was recorded by a conditioned pain modulation paradigm. A support vector machine was used to screen sensory parameters for their predictive power of pregabalin efficacy.<h4>Results</h4>The pregabalin responders group was hypersensitive to electric tetanic stimulation of the pancreatic area (ePDT ratio 1.2 (0.9-1.3)) compared to non-responders group (ePDT ratio: 1.6 (1.5-2.0)) (P = 0.001). The electrical pain detection ratio was predictive for pregabalin effect with a classification accuracy of 83.9% (P = 0.007). The corresponding sensitivity was 87.5% and specificity was 80.0%. No other parameters were predictive of pregabalin or placebo efficacy.<h4>Conclusions</h4>The present study provides first evidence that quantitative sensory testing predicts the analgesic effect of pregabalin in patients with painful chronic pancreatitis. The method can be used to tailor pain medication based on patient's individual sensory profile and thus comprises a significant step towards personalized pain medicine.
format	article
author	Søren S Olesen Carina Graversen Stefan A W Bouwense Harry van Goor Oliver H G Wilder-Smith Asbjørn M Drewes
author_facet	Søren S Olesen Carina Graversen Stefan A W Bouwense Harry van Goor Oliver H G Wilder-Smith Asbjørn M Drewes
author_sort	Søren S Olesen
title	Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
title_short	Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
title_full	Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
title_fullStr	Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
title_full_unstemmed	Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
title_sort	quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/ae8fcf81ac2a42dc8f3f2fdcf11460f5
work_keys_str_mv	AT sørensolesen quantitativesensorytestingpredictspregabalinefficacyinpainfulchronicpancreatitis AT carinagraversen quantitativesensorytestingpredictspregabalinefficacyinpainfulchronicpancreatitis AT stefanawbouwense quantitativesensorytestingpredictspregabalinefficacyinpainfulchronicpancreatitis AT harryvangoor quantitativesensorytestingpredictspregabalinefficacyinpainfulchronicpancreatitis AT oliverhgwildersmith quantitativesensorytestingpredictspregabalinefficacyinpainfulchronicpancreatitis AT asbjørnmdrewes quantitativesensorytestingpredictspregabalinefficacyinpainfulchronicpancreatitis
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Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis.

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