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 […]
John J. BURKE
Charles E. ARGOFF MD, CPE
Charles E. ARGOFF MD, CPE
- Relistor (methylnaltrexone) Use Expanded to Noncancer Patients
The FDA approved Movantik (nalogel) last month and the anticonstipation medication already has competition. First approved in 2008, injectable Relistor (methylnaltrexone) treated constipation in patients taking opioids for chronic pain related to cancer. Now, it is estimated that over 10 million people will benefit from the new indication. Results from one study were encouraging: a third of treated patients had a bowel movement with 4 hours, and half moved their bowels before even receiving a second dose. The fact that Relistor (methylnaltrexone) has to be injected may keep some patients away. It is likely that an oral version will be introduced in the future. To read the article, click here. To read about the FDA approval of Movantik (naloxegol), click here.
- Noncancer Pain Management With Painkillers Not Helping Daily Functioning
In a notable first, the American Academy of Neurology (AAN) is stating that overuse of opioids for noncancer pain isn’t doing anyone any good. “The risks for chronic opioid therapy for some chronic conditions such as headache, fibromyalgia, and chronic low back pain likely outweigh the benefits.” That’s part of the conclusion of a new position paper from AAN, as published in its Neurology journal this month. For noncancer pain, “powerful painkillers do little to improve patients’ daily functioning.” Weighing the hazards of opioid use—addition and overdose—against potential benefits, the AAN states that healthcare practitioners should find other treatment methods to help manage chronic pain, such as cognitive behavioral therapy. Insurers should cover alternative pain management approaches to combat ineffective drug therapy, which is now the default. Chronic inefficient opioid use must be replaced by other treatment methods that do work, and which insurers should cover. To read the article, click here. To read the complete journal article, click here.
- Nanodevice Sensitive Enough for Trace Level Biomarkers
A nanodevice in development at the University of Alabama in Huntsville and the Joint School of Nanoscience and Nanoengineering in Greensboro, North Carolina, appears to have the sensitivity to detect cancer “at the small cluster of cells level” where it is easier to treat, according to research scientists. How? Nanodots too small to see provide a biochemical link for specific antibodies to attach to. One test measures interleukin-6 levels, which if increased could signal inflammation and therefore possibly other conditions. These nanodevices could test the bloodstream without outside laboratory testing: results would be sent to a cellphone app. Funding is needed, and researchers feel this technology could make a big difference in not only detecting cancers such as prostate but also help to fight outbreaks such as the Ebola virus. To read the article, click here.
- Damaged Nerve Tissues May Be Repaired By Placenta-Derived Cells
A first-of-its-kind study in an article in the journal Multiple Sclerosis and Related Disorders states that patients with MS may safely be treated with placenta-derived cells. Safety was determined, and the next step is efficacy. Lead investigator Fred Lublin, MD, Director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis, and Professor of Neurology at Icahn School of Medicine at Mount Sinai, stated that “we could be looking at a new frontier in treatment for” MS. In the small study of 16 MS patients, no subjects showed worsening of symptoms, which is always a risk due to immune system altering, and the majority of patients had improved or stable disability levels. To read the article, click here.
Department of Public Health and Community Medicine
Tufts Medical Center