Funding Announcements

Development of Opioid and Adjuvant Fixed Combination Dosage Forms for the Treatment of Chronic Pain with Reduced Addiction Potential (R41/R42)

This funding opportunity announcement seeks small business organizations to develop opioid and adjuvant drug combinations within a single dosage form for treatment of a pain condition. The drug combination should provide improved analgesia when compared with the same dose (morphine equivalents) of opioid monotherapy. Such dosage forms should minimize opioid exposure while optimizing analgesia to reduce risk of addiction and limit severity of other opiate adverse effects.

When designing this new product, investigators should consider FDA guidance (21 CFR 300.50) and address the following issues. Both of the agents contained in the proposed new product should currently have at least one existing FDA-approved indication, as well as some existing clinical evidence to support the use of the chosen adjuvant: opioid combination and a reasonable expectation that the combination will present minimal drug-drug interaction concerns. The application should emphasize available evidence that the chosen drugs and doses in the combination will allow a substantial patient population to gain sufficient analgesic value from the contained opioid dose while the adjuvant dose remains within a safe and effective "therapeutic window". One example of a potentially viable adjuvant is gabapentin, a drug known to reduce neuropathic pain and to which patients typically exhibit no more than mild adverse effects. Gabapentin does not typically induce substantial drug interactions because it is eliminated as parent drug by renal excretion and does not extensively bind to blood proteins.

The adjuvant should be chosen for a capacity to increase overall analgesia, rather than an ability to reduce opioid adverse effects. For example, inclusion of a poorly absorbed opioid receptor antagonist, with the intent of reducing constipation, would not be considered of high programmatic interest.

The combination dosage form proposed by the application should provide sustained relief when it is the only analgesic used and is administered no more than three times in a 24-hour period. The formulation should be such that a patient with reasonable mobility is able to self-administer the drug (e.g., oral dosage form).

The application should propose late-stage drug development-oriented studies that significantly drive the project towards an ultimate aim of a New Drug Application [505(b)(1 or 2)] or Abbreviated New Drug Application [505(j)] for the treatment of a long-term pain condition.

Studies planned for Phase1 of the project should focus on issues that concern the feasibility of the project. The exact nature of such studies will differ depending on the proposed drug combination project.

Studies that might be appropriate for Phase1 STTR applications include, but are not limited to

• development of a formulation that safely delivers the desired amount of both agents over an appropriate dosing interval
  
• preclinical studies demonstrating additive or synergistic analgesia with the opioid-adjuvant combination
  
• studies to provide data for an Investigational New Drug (IND) submission, such as short-term stability studies
  
• pre-IND consultations with an FDA project management group and development of the IND documentation.

Examples of projects appropriate for the Phase2 of an STTR award might include

• pharmacokinetic absorption and disposition studies to demonstrate the bioequivalence between approved dosage forms and the proposed product
  
• proof of concept clinical studies. Appropriate outcome measures might aim to detect and distinguish value added by an opioid adjunctive therapy, whether due to improved analgesia or reduced required opioid dosage.

Submissions will be accepted beginning March 5, 2014, and letters of intent are due 30 days before applications are due. For more information about this funding opportunity, visit the NIH grants page.

Education

Register for the 33rd Annual Scientific Meeting

Discover the latest information about research, diagnosis, treatment, and management of acute pain, chronic cancer and noncancer pain, and recurrent pain.

APS will hold its 33rd Annual Scientific Meeting in Tampa, FL, April 30–May 3.

The 2014 educational program will include more than 35 educational sessions featuring a range of basic science, clinical, and research sessions.

Additional highlights include

• early career forum
  
• Kerr and Fordyce Award lectures
  
• Clinical and Basic Science Data Blitz
  
• a keynote address on healthcare reform by David Newman, MD
  
• plenary lectures by Mark Zylka, PhD; Camilla Svensson, PhD MPharmSci; and John Loeser, MD
  
• a Global Year Against Pain Lecture on orofacial pain by Brian Schmidt, DDS MD PhD
  
• unopposed author-attended poster sessions that feature cutting-edge research
  
• continuing education credit for nurses, physicians, psychologists, and pharmacists.

Additional information regarding the 2014 Annual Scientific Meeting can be found on the APS website. Register by March 24 to receive $100 off your registration fee. Register now!

Interested in Attending Research-Focused Sessions?

The APS Annual Scientific Meeting serves as a platform for interdisciplinary exchange among scientists, pain clinicians, and other professionals. Educational sessions are designed to enhance research or clinical skills pertinent to pain management.

Attend one of the following research sessions to expand your knowledge and learn about new scientific discoveries:

Thursday, May 1
(102) Plenary Lecture
Sensory Mechanism for Heat Inhibition of Cold
Mark Zylka, PhD

(202) From Brain to Spine and Beyond: Tracking Low Back Pain from the Nervous System to Peripheral Tissues
Laura Stone, PhD (Moderator); Helene Langevin, MD; David Seminowicz, PhD

(300) Optogenetics in Pain
Brian Davis, PhD (Moderator); Robert Gereau, PhD; Benedict Kolber, PhD

Friday, May 2
(103) Plenary Lecture
Beyond Inflammation—Exploring Mechanisms of Persistent Pain in Arthritis
Camilla Svensson, PhD

(401) Emerging Themes in G Protein-Coupled Receptor Signaling
Derek Molliver, PhD (Moderator); Laura Bohn, PhD; Nathaniel Jeske, PhD; Lakshmi Devi, PhDMSc

(402) The Role of Mitochondria in Chronic Pain
Shuanglin Hao, MD PhD (Moderator); Jin Chung, PhD; Jon Levine, MD PhD; Daniela Salvemini, PhD

(501) Pain Control by Novel Lipid Mediators: Preclinical and Clinical Studies on Pro- and Anti-Inflammatory Mediators
Ru-Rong Ji, PhD (Moderator); Christopher Ramsden, MD; Daniela Salvemini, PhD

(600) Function and Dysfunction of Potassium Channels in Nociceptors: Implications in the Development and Treatment of Neuropathic Pain
Manuel Covarrubias, MD PhD (Moderator); Hui-Lin Pan, MD PhD; Yuan-Xiang Tao, PhD

Saturday, May 3
(801) Novel Modulators and Signaling Mechanisms in Inflammatory Pain
Yuriy Usachev, PhD (Moderator); David Clark, MD PhD; Durga Mohapatra, PhD

(900) Circulating MicroRNA Signatures of Chronic Pain
Asma Khan, PhD BDS (Moderator); Seena Ajit, PhD; Andrea Nackley, PhD; Ahmet Sacan, PhD

To learn more about individual sessions, view the schedule of events.

Applications Now Being Accepted for Young Investigator Travel Support

APS is offering Young Investigator travel support for the 2014 APS Annual Scientific Meeting. A limited number of funding awards will be available to individuals presenting poster abstracts at the meeting, April 30–May 3 in Tampa, FL. Applicants may be from any research training background (basic or clinical science, psychology, medicine, or biostatistics) and may be at any level in training (students, residents, predoctoral trainees, postdoctoral fellows, and those who have completed their postdoctoral training within the past 3 years). Applicants must be APS members and must have an abstract accepted for presentation. Applications from nonmembers will not be considered.

To apply for funding, complete the Young Investigator travel support online application, which is now available on the APS website. Note that an applicant’s abstract must be accepted for presentation before he or she is eligible to submit an application for this grant. The listing of accepted abstracts, by primary author, is now available on the APS website. Please check the abstract acceptance list before applying for a Young Investigator award.

Applications must be completed online by February 10.

If you have difficulty completing the application, contact APS at 847.375.4715. Applications will be reviewed by the APS Scientific Program Committee, and stipends will be awarded in late February. Notifications will be sent to applicants in March. Those applicants selected to receive a 2014 award will receive their travel grants at the annual meeting.

Clinical and Basic Science Data Blitz

The Clinical and Basic Science Data Blitz will be held Wednesday, April 30, 6–8 pm as part of the 33rd APS Annual Scientific Meeting in Tampa. The blitz will include selected presentations of new research in a rapid format, where presenters will have 5 minutes to present data and 5 minutes to answer questions from the audience. The blitz will be moderated by David Seminowicz, PhD, and Benedict Kolber, PhD.

APS will issue a Call for Submissions for the Data Blitz in February 2014.

2014 Poster Abstract Program

APS received more than 500 abstract submissions for the 2014 APS Annual Scientific Meeting. The list of accepted abstract titles and primary authors’ names is now available on the Accepted Poster Abstracts page of the APS website. Acceptance letters were mailed to primary authors on December 17, 2013.

The 2014 APS abstract texts will be available in a searchable database on the Journal of Pain’s website in April. APS will provide a link to the database via the Poster Information page of the APS site.

Members

Member Spotlight

Salimah H. Meghani, PhD MBE RN FAAN
Associate Professor
Department of Biobehavioral Health Sciences
Associate Fellow
Center for Bioethics
University of Pennsylvania
Philadelphia, PA

How has membership in APS been of value to you and your professional development?
I joined APS as a doctoral student and have continued my membership since. I found APS relevant both as a student and as an early-mid career researcher. While advantages range from cutting-edge, data-driven learning to dissemination opportunities, the most salient advantage for me is to network with like- and unlike-minded interdisciplinary scholars; the former help me maintain momentum and the latter challenge me—both towards the advancement of rigorous scholarship. To this end, I have found engagement in the Pain Disparities Shared Interest Groups (SIG) particularly valuable. My experiences as chair of this SIG have been enriching, particularly as we seek to re-invigorate the SIG and expand its scope beyond racial and ethnic disparities to encompass other relevant domains such as addiction and physical and cognitive disabilities. This process has challenged me to think broadly about pain disparities, which has enhanced my own scholarship and continued professional development. I have also developed a network of friends and mentors whom I look forward to seeing each year.

What is your area of specialty?
I am an academic researcher with formal training in nursing, bioethics, and health disparities. My research focuses on understanding and addressing sources of disparities in pain care and outcomes.

What has been a highlight of your work? Perhaps you and your staff are proud of a certain project or accomplishment.
Our team recently spearheaded two major projects to inform the debate on pain treatment disparities. The first project, “Advancing a National Agenda to Eliminate Disparities in Pain Care: Directions for Health Policy, Education, Practice, and Research,” was a culmination of a series of efforts to convert rigorous evidence on pain care disparities to education, research, and policy targets. This special report (featured in Pain Medicine) addresses many of the issues and challenges raised in the IOM report, Relieving Pain in America. In addition, our team is the first to report a meta-analysis of 20 years of cumulative evidence on racial and ethnic disparities in analgesic treatment for pain in the U.S. This work, “Time to Take Stock: A Meta-Analysis and Systematic Review of Analgesic Treatment Disparities for Pain in the United States,” uncovered concerning disparities in pain care and also provided a window into the sources of these disparities.

While we have established that pain care disparities exist and its magnitude is concerning, we have not yet been able to identify workable interventions to these disparities. The field definitely needs to move in this direction.

What initially sparked your interest in working in your field? Briefly describe your career path.
My initial interest in this topic stemmed from exposure to the widespread suffering experienced by cancer patients in Pakistan, my country of origin, due to constrained availability of opioids for cancer pain relief. The works of Pain and Policy Studies Group on documenting these global and regional disparities were instructive. These early experiences engendered my dedication to a line of scientific inquiry focused on the causes and consequences of disparities in pain care. As a doctoral student in the U.S., I started investigating clinical disparities in cancer pain outcomes and how preference and negotiation for analgesic treatment for cancer pain is shaped. This work led to an NIH-funded program of research, including an NIH Challenge grant to understand heuristics underlying cancer pain treatment decision-making for African Americans and Whites. This work has uncovered opportune targets for interventions, and my current work is moving in this direction.

Who is your favorite role model—and why?
It is difficult to name one since I have been inspired by so many individuals whose works have established pain care disparities as a formal scientific area in need of strong research, advocacy, scholarship, and funding commitment: Knox Todd, Charles Cleeland, Carmen Green, Richard Payne, Raymond Tait, John Chibnall, April Vallerand, and Karen Anderson, to name a few. Some of these individuals have even become valuable mentors.

Member Benefit: Networking Opportunities

Networking opportunities in APS are abundant. These opportunities are available at the Annual Scientific Meeting through shared interest groups and in regional activities, committees, task forces, and other informal gatherings.

The Annual Scientific Meeting gives you the opportunity to network by interacting with the best and brightest in pain research. You will be able to connect with colleagues across settings and disciplines at numerous networking events, including special interest group meetings and the opening reception with exhibits and posters. You will also have the chance to discuss your own research and clinical observations while meeting with more than 400 poster presenters to learn about their work and future research directions.

Summaries

The Journal of Pain Highlights

The following highlights summarize selected articles from The Journal of Pain (Volume 15, Number 1, January 2014 Issue).

Acceptance and Commitment Therapy for Chronic Pain: Evidence of Mediation and Clinically Significant Change Following an Abbreviated Interdisciplinary Program of Rehabilitation
Kevin Vowles, Katie Witkiewitz, Gail Sowden, and Julie Ashworth; Department of Psychology, University of New Mexico, Albuquerque, New Mexico; IMPACT Community PainService, Haywood Hospital, Burslem, Stoke-on-Trent, United Kingdom; Arthritis Research UK National Primary Care Centre, Keele University, Keele, United Kingdom

Numerous studies show favorable outcomes achieved by multidisciplinary pain management programs. The latest is University of New Mexico research reporting that Acceptance and Commitment Therapy (ACT) improves quality of life for individuals with persistent pain by significantly reducing disability, depression, and pain-related anxiety. The study appears in The Journal of Pain.

The primary treatment process for ACT is psychological flexibility or a willingness to experience pain when pain control efforts are ineffective or impair everyday functioning. The research team sought to examine individual patterns of change during ACT treatment using a multilevel mediation model testing the association between psychological flexibility and treatment outcomes over time. The study also evaluated the reliability and clinical significance of ACT.

The authors hypothesized that treatment completers would experience improvement in physical and emotional functioning, reduce their healthcare utilization and analgesic use, and increase physical movement. Seventy-eight patients provided data in surveys.

Results showed that 46.2% of patients achieved significant changes in disability, depression, and pain-related anxiety; and 58% achieved reliable change in at least one area of functionality. The authors concluded their results indicate that at completion of treatment and after 3 months, a significant proportion of patients were functioning reasonably well. This supports an approach to treating chronic pain that is focused on helping patients live better with pain.

Comparisons of Patient and Physician Assessment of Pain-Related Domains in Cancer Pain Classification: Results from a Large International Multicentre Study
Cinzia Brunelli, Stein Kaasa, Anne Kari Knudsen, Marianne Jensen Hjermstad, Alessandra Pigni, and Augusto Caraceni; Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Cancer Clinic, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway; Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Ulleval, Oslo, Norway

Despite the availability of effective pain control guidelines, sub-optimal pain management is still reported in about 42% of oncology patients. Pain, therefore, remains one of the most prevalent and feared symptoms among people with cancer.

Italian researchers writing in The Journal of Pain compared physician pain assessments to evaluations of cancer patients with incident/breakthrough pain, neuropathic pain, and psychological distress. Most of the evidence in previous studies shows medium to low concordance between physician and patient pain intensity ratings.

The main finding of the study was that patient-structured self assessments of incident/breakthrough pain, neuropathic pain, and psychological distress give better classification and have higher discriminative validity for cancer pain than physician clinical assessments. The authors noted that the study results support development of a classification system for cancer pain and indicate that patients’ self assessment of subjective symptoms using simple standardized and validated tools should be integrated in future pain classification systems.

PAIN Highlights

The following highlights summarize selected articles from PAIN (Volume 155, Number 1, January 2014 Issue).

Pain in Hospitalized Children: Effect of a Multidimensional Knowledge Translation Strategy on Pain Process and Clinical Outcomes
Bonnie J. Stevens, Janet Yamada, Carole A. Estabrooks, Jennifer Stinson, Fiona Campbell, Shannon D. Scott, and Greta Cummings. CIHR Team in Children’s Pain; The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; and University of Alberta, Edmonton, Alberta, Canada

A significant proportion of hospitalized children receive inadequate pain assessment and management. This is particularly apparent within the context of procedural pain. Moderate to severe pain in children has long been associated with short- and long-term physiological and psychological adverse effects. Effective pain-management strategies are associated with more rapid and full recoveries and decreased costs to the healthcare system. The challenge is not solely one of knowledge generation but also of knowledge translation (KT). KT is defined as a process that reduces the gap between research and practice through the dissemination and exchange of research evidence and its application to clinical practice to improve health outcomes, quality of care, and healthcare systems. This study addressed the gap between research and practice in the assessment and management of procedural pain in children through the implementation and evaluation of a multidimensional KT intervention, Evidence-Based Practice for Improving Quality (EPIQ).

EPIQ was adapted and implemented across a broad national hospitalized pediatric population and unit type, resulting in applicable outcome data. The purpose of this study was to evaluate the effectiveness of EPIQ in improving pain processes (pain assessment and management) and clinical outcomes (pain intensity) in pediatric hospital units in Canada.

Chart reviews at baseline (time 1) and intervention completion (time 2) determined the nature and frequency of painful procedures and of pain assessment and pain management practices. Trained pain experts evaluated pain intensity 6 months post-intervention (time 3) during routine scheduled painful procedures. Generalized estimating equation models compared changes in outcomes between EPIQ and standard care units over time. EPIQ units used significantly more validated pain assessment tools and had a greater proportion of patients who received analgesics and physical pain management strategies. Mean pain intensity scores were significantly lower in the EPIQ group. Comparisons of moderate (4–6/10) and severe (7–10/10) pain, controlling for child and unit-level factors, indicated that the odds of having severe pain were 51% lower for children in the EPIQ group.

EPIQ was an effective multidimensional KT strategy for reducing pain in hospitalized children. Significant practice improvements were seen in the EPIQ intervention group, specifically in the use of validated pain assessment measures and pharmacological and physical interventions to manage procedural pain. Additional exploration of the influence of contextual factors on research use in hospital settings is required to explain the variability in pain processes and clinical outcomes.

Irritable Bowel Syndrome in Female Patients Is Associated With Alterations in Structural Brain Networks
Jennifer S. Labus, Ivo D. Dinov, Zhiguo Jiang, Cody Ashe-McNalley, Alen Zamanyan, Yonggang Shi, Jui-Yang Hong, Arpana Gupta, Kirsten Tillisch, Bahar Ebrat, Sam Hobel, Boris A. Gutman, Shantanu Joshi, Paul M. Thompson, Arthur W. Toga, and Emeran A. Mayer; Oppenheimer Family Center for Neurobiology of Stress, Pain and Interoception Network, David Geffen School of Medicine at UCLA, Los Angeles, CA; Laboratory of Neuro Imaging, Department of Neurology, University of California, Los Angeles; Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles; and Brain Research Institute, University of California, Los Angeles

Alterations in gray matter (GM) density/volume and cortical thickness have been demonstrated in small and heterogeneous samples of subjects with differing chronic pain syndromes, including irritable bowel syndrome (IBS). Aggregating across seven structural neuroimaging studies conducted at University of California, Los Angeles, between August 2006 and April 2011, investigators examined group differences in regional GM volume in 201 predominantly premenopausal women (82 of whom had IBS). Applying graph theoretical methods and controlling for total brain volume, global and regional properties of large-scale structural brain networks were compared between the group with IBS and the healthy control (HC) group.

Lower GM volumes were identified in the insula, cingulate, amygdala, hippocampus, putamen, and frontal regions, whereas greater GM volumes were observed in S1 in patients with IBS. Many of the differences were accounted for by histories of early adverse life events but not trait anxiety. Similarities and differences were observed between the two groups in global and regional network characteristics based on regional GM volume changes.

The observed changes (increases and decreases) in GM volume and alterations in regional network properties identified in this study may reflect different pathophysiological components of the disease processes underlying IBS symptoms, including increased sensitivity to somatic and visceral stimuli (higher GM volumes in S1); associated increases in emotional arousal (lower GM in the hippocampus in IBS); and other chronic-pain–related mechanisms (lower GM in insula and cingulate cortices, and differences in insula, cingulate, thalamus, and brain stem network properties). Future studies in large, well-phenotyped samples of patients, as well as in animal models of chronic pain, will be required to address this topic.

The Clinical Journal of Pain Highlights

The following highlights summarize selected articles from The Clinical Journal of Pain (Volume 30, Number 1, January 2014 Issue).

Coping and Recovery in Whiplash-associated Disorders: Early Use of Passive Coping Strategies Is Associated With Slower Recovery of Neck Pain and Pain-Related Disability
Linda J. Carroll, Robert Ferrari, J. David Cassidy, and Pierre Côté; Department of Public Health Sciences, Alberta Centre for Injury Prevention and Research; Departments of Medicine and Rheumatic Diseases, University of Alberta, Edmonton, AB; Division of Outcomes and Population Health, Toronto Western Research Institute; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto; and Faculty of Health Sciences and UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), Toronto, ON, Canada; and Institute of Sport Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark

A large body of evidence indicates that coping style may influence health outcomes. Coping style has been shown to influence disability in a wide variety of painful disorders. Most pain-coping research has studied populations with chronic pain, yet there is evidence that acute injury outcome may be equally influenced by coping style. Specifically, regarding whiplash-associated disorders (WAD), pain-coping strategies assessed within several days of injury have been associated with concurrent disability and predictions of whether patients with WAD comply with referral to active rehabilitation.

This study was designed to determine the predictive association between coping style and neck pain recovery and recovery of disability during the first year after WAD onset. Participants (2,986 patients with traffic-related WAD) were assessed at baseline; 6 weeks; and 4, 8, and 12 months post-injury. Coping was measured at 6 weeks using the Pain Management Inventory, and neck pain recovery was assessed at each subsequent follow-up using a 100-mm visual analogue scale (VAS).

This population-based cohort study showed that those reporting a passive coping style 6 weeks after WAD onset exhibited a slower rate of recovery from neck pain and neck pain disability. At 6 weeks post-collision, those who reported they were likely to restrict social activities because of pain, focus on pain, or the desire for better pain medications took longer to recover from neck pain or disability, even after adjusting for confounders including baseline pain and disability. These findings add to the growing body of evidence suggesting that when assessed within the first weeks after an injury, coping is associated with subsequent recovery. The analyses identified post-injury symptoms (pain and depressive symptomatology) as the most relevant confounders. Even after adjusting for pain intensity, depression, and pain disability, passive coping predicted slower recovery. In the case of active coping, the associations with pain severity, depression, and disability were not strong, and even before adjusting for these indices of severity, there was little or no association between active coping and recovery. This suggests that active coping is not a reflection of neck condition severity. A passive coping style in general has a negative influence on health and health outcomes even before an injury occurs, and those who cope passively also react more negatively to health conditions.

Identifying patients at an early stage who are likely to engage in passive coping strategies seems to be key, and “flagging” those at risk for slowed recovery may provide an opportunity to modify coping style by encouraging compliance with exercise therapy and discouraging reliance on prescription medications.

Factors Associated With Outcome After Superior Hypogastric Plexus Neurolysis in Cancer Patients
Caleb E. Kroll, Brandon Schartz, Marlis Gonzalez-Fernandez, Andrew H. Gordon, Mosunmola Babade, Michael A. Erdek, Nagy Mekhail, and Steven P. Cohen; Departments of Anesthesiology and Critical Care Medicine, Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore; Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD; and Department of Pain Medicine, Cleveland Clinic Foundation, Cleveland, OH

Pain associated with pelvic cancer is one of the most debilitating symptoms experienced by affected patients. The superior hypogastric plexus (SHP) is located at the anterior aspect of the L5 and S1 vertebrae, and traverses the disk between these levels. It is an extension of the aortic plexus below the aortic bifurcation and contains almost exclusively sympathetic fibers and visceral afferents. Afferent pain fibers innervating pelvic organs travel with sympathetic nerves, trunks, ganglia, and rami, thus, interrupting the sympathetic chain at this level can be used as a method to treat pelvic cancer pain. Although SHP neurolysis (SHP-N) can provide significant benefit in some patients, it is unclear why the procedure does not provide relief for all patients with pelvic cancer. The purpose of this study was to identify the demographic, clinical, and treatment parameters associated with a successful SHP-N.

Patients who underwent SHP-N after a positive prognostic block were identified based on diagnostic classification and procedural codes from databases at two large teaching hospitals. Demographic, clinical, and treatment factors were examined for their association with treatment success, which was defined as at least 50% pain relief lasting at least 1 month.

Of 32 patients with sufficient medical records for analysis, 53% experienced a positive outcome. Those with a positive outcome were older (mean age 59.6 years), less likely to have pelvic pain, and more likely to have bladder cancer (those with gynecological and colorectal cancers experienced less treatment success). In stratified analysis, women were more likely to have a positive outcome if they did not have pelvic pain. Ten of the 13 patients without pelvic pain experienced a positive outcome.

Selecting patients based on demographic and clinical variables may improve treatment outcomes for SHP-N. Larger prospective studies are needed to confirm these results and better refine selection criteria. These results demonstrate that SHP-N can provide significant, prolonged pain relief in patients with cancer-related lower abdominal, pelvic, or perineal pain.

Research

Rita Allen Foundation Request for Applications Deadline Extended

The Rita Allen Foundation (RAF) and APS recently announced the 2014 Rita Allen Foundation Award in Pain, for which the deadline has been extended to February 3. The RAF and APS award two grants in the amount of $50,000 annually for a period of up to 3 years to those research proposals demonstrating the greatest merit and potential for success.

Candidates must have completed their training and must provide persuasive evidence of distinguished achievement or extraordinary promise in basic science research in pain. Candidates should be in the early stages of their career with an appointment at faculty level. The entire award is to be allocated to projects specifically chosen by the recipient. Overhead is not supported.

Click here to learn more about the Rita Allen Foundation Award in Pain.

Important Dates

Rita Allen Foundation Award in Pain—Deadline Extended
Closes Monday, February 3, 2014
Learn More

Young Investigator Travel Support Applications
Closes Monday, February 10, 2014
Learn More

Clinical and Basic Science Data Blitz Submissions
Opens in February
Learn More

Annual Scientific Meeting Early-Bird Deadline
Monday, March 24
Register Now

Call for Submissions

Do you have a topic that is relevant to APS members? Is there a member who is doing work that APS should spotlight? Is there a funding opportunity APS members need to know about? Please submit stories, events, and more to enews@americanpainsociety.org for consideration.