Colleen M. FiTZGERALD MD, MS
Michael R. CLARK MD, MPH, MBA
A prominent psychiatrist and pain educator discusses the challenge of managing patients with chronic pain who also suffer with borderline personality disorder and depression, including the special difficulties associated with demanding, noncompliant, and high-utilizer patients. Dr. Clark is Vice Chair of Clinical Affairs, Johns Hopkins University School of Medicine, the Director of the Adolf Meyer […]
Joseph P. FURMAN JD
Charles E. ARGOFF MD, CPE
- Pfizer Announces Decision to Terminate Developmental Agreement
Progress on a new abuse resistant extended release oxycodone formulation was potentially impacted by the announcement this week by Pfizer that it is terminating its agreement with Pain Therapeutics to develop and commercialize the drug Remoxy®. A spokesperson for Pain Therapeutics said that the company remains “enthusiastic” about the prospect of finding new partners with which to work on developing and commercializing the analgesic. Remoxy is an extended release oral analgesic intended to treat severe pain that requires daily, around the clock management. The drug is based on Durect Corp.’s patent-pending Oradur technology, described by the company as designed to “discourage common methods of tampering associated with prescription opioid analgesic misuse and abuse.” The Pfizer decision followed an internal review conducted in response to receipt of a Complete Response Letter from FDA in 2011 rejecting approval of the medication. Read a news story with links to additional press information from the companies here. An additional perspective on the decision and potential impact may be read here.
- New Resources Made Available to Prescribing Clinicians
At its annual meeting earlier this month, the National Association of State Controlled Substances Authorities (NASCSA) formally endorsed the Federation of State Medical Boards’ (FSMB) newly revised "Model Policy on the Use of Opioid Analgesics in the Treatment of Chronic Pain" by unanimous vote. FSMB policy is intended as a resource for use by state medical boards in educating their licensees about cautious and responsible prescribing of controlled substances, while providing guidelines to help avoid the overtreatment or under-treatment of patients with pain. Representing an update to its Model Policy of 2004, the new policy acknowledges that evidence for the risks associated with opioids has surged, while evidence for benefits of long-term opioid use has remained insufficient. It also recognizes that under-treatment of chronic pain in the US continues to be a serious public health issue. The FSMB has recently published an updated and expanded edition of “Responsible Opioid Prescribing: A Clinician's Guide,” a resource for clinicians involved in opioid therapy for chronic pain. Read a news story about the proceedings, with link to more information about the FSMB and resources, here.
- American Migraine Foundation Encourages Visits to New Online Site
In a news release yesterday, The American Migraine Foundation announced a redesign and expansion of its website, www.AmericanMigraineFoundation.org, to provide a wealth of consumer-friendly information on preventing, treating and coping with migraine and other headache disorders. The site is described as the companion site to the American Headache Society, an information resource for clinicians and researchers working in migraine. Some 36 million Americans live with migraine, more than have asthma or diabetes combined. An estimated 3 to 7 million of these live with chronic migraine, a highly disabling neurological disorder. The enhanced website includes a new monthly “Spotlight,” where migraine sufferers and the public can turn for more detailed information about living and managing many aspects of migraine. “Spotlight” will change topics approximately once a month. Read more about this new resource here.
- Study Finds Correlation Between Pre-treatment Pain and Prognosis for Survival
Writing in The Journal of Pain, researchers at M.D. Anderson Cancer Center report that pre-treatment pain intensity is an independent survival predictor for patients with head and neck cancer. Pain is a frequent early sign of head and neck cancer, as a result of destructive lesions and direct tissue and bone involvement. Head and neck cancer is the sixth most common malignancy worldwide, with 54,000 cases diagnosed in the US each year. The study assessed over 2,000 patients who were newly diagnosed with head and neck cancers. Among those with oral cancer, overall five-year survival was 31 percent for patients who reported severe pain and 52 percent for those without severe pain. The survival differentiation was similar in patients with pharyngeal cancer. The authors noted that patients who present with severe pain at diagnosis should be closely monitored and promptly treated for pain symptoms. Read a news story about the findings here.
Department of Public Health and Community Medicine
Tufts Medical Center