Evidence map›Paper›PMID 27412526›Full record

Trial reportBMC musculoskeletal disorders2016

Variability in conditioned pain modulation predicts response to NSAID treatment in patients with knee osteoarthritis.

Robert R Edwards, Andrew J Dolman, Marc O Martel, Patrick H Finan, Asimina Lazaridou, Marise Cornelius, Ajay D Wasan

2 registry-linked trialsAbstract readClinical TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 64 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01383954 phase4completednot on this map

The Efficacy of Diclofenac Gel for Breakthrough Pain and the Neuropathic Components of Pain in Knee Osteoarthritis

TypeinterventionalSponsorBrigham and Women's HospitalRan2011 to 2012Enrolled52ConditionsKnee OsteoarthritisArmsDiclofenac Gel
NCT05986513 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Investigating Brain Abnormalities in People With Knee Osteoarthritis Using MRI: a Nociplastic Pain Mechanism Based Assessment

TypeinterventionalSponsorToronto Rehabilitation InstituteRan2023 to 2025Enrolled66ConditionsChronic Pain, Central Sensitisation, Knee OsteoarthritisArmsCold Pressor Gel Test
3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Robert R EdwardsDepartment of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA. RREdwards@partners.org.
Andrew J DolmanDepartment of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
Marc O MartelDepartment of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
Patrick H FinanDepartment of Psychiatry, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 100, Baltimore, MD, 21224, USA.
Asimina LazaridouDepartment of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
Marise CorneliusDepartment of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.
Ajay D WasanDepartment of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St, Suite 302, Chestnut Hill, MA, 02467, USA.

Funding

Brain Mechanisms Underlying CBT-Related Reductions in FibromyalgiaR01AR064367 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI EDWARDS, ROBERT R, NAPADOW, VITALY · 2014 to 2018
$4.0M
Biobehavioral Risk Factors for Persistent Pain following Total Knee ArthroplastyR01AG034982 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI EDWARDS, ROBERT R · 2010 to 2014
$3.2M
Catastrophizing and Cytokine Responses to Acute Pain in the Rheumatic DiseasesR21AR057920 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI EDWARDS, ROBERT R · 2010 to 2011
$431k
NIAMS NIH HHS R01 AR064367NIAMS NIH HHS R21 AR057920NIA NIH HHS R01 AG034982
6 · The paper itself

Abstract

backgroundPatients with painful knee osteoarthritis (OA) demonstrate hyperalgesia and altered pain-modulatory responses. While some prior work has demonstrated cross-sectional associations between laboratory and clinical pain measures, it is unknown whether individual variability in quantitative sensory testing (QST) responses at baseline can prospectively predict analgesic treatment responses.

methodPatients with knee OA (n = 35) were compared on QST responses to a demographically-matched pain-free control group (n = 39), after which patients completed a month-long treatment study of diclofenac sodium topical gel (1 %), applied up to 4 times daily.

resultsOA patients demonstrated reduced pain thresholds at multiple anatomic sites, as well as reduced conditioned pain modulation (CPM) and enhanced temporal summation of pain. The most pain-sensitive patients tended to report the most intense and neuropathic OA pain. Following diclofenac treatment, the knee OA cohort showed a roughly 30 % improvement in pain, regardless of the presence or absence of neuropathic symptoms. Baseline CPM scores, an index of endogenous pain-inhibitory capacity, were prospectively associated with treatment-related changes in clinical pain. Specifically, participants with higher CPM at baseline (i.e., better functioning endogenous pain-inhibitory systems) showed more reduction in pain at the end of treatment (p < .05).

conclusionsThese results support prior findings of amplified pain sensitivity and reduced pain-inhibition in OA patients. Moreover, the moderate to strong associations between laboratory-based measures of pain sensitivity and indices of clinical pain highlight the clinical relevance of QST in this sample. Finally, the prospective association between CPM and diclofenac response suggests that QST-based phenotyping may have utility in explaining inter-patient variability in long-term analgesic treatment outcomes.

trial registrationClinicalTrials.Gov Identifier: NCT01383954 . Registered June 22, 2011.

Indexed as

Administration, TopicalAnti-Inflammatory Agents, Non-SteroidalCase-Control StudiesDiclofenacFemaleGelsHumansHyperalgesiaMaleMiddle AgedOsteoarthritis, KneePainPain ManagementPain MeasurementPain ThresholdTreatment OutcomeAnti-Inflammatory Agents, Non-SteroidalDiclofenacGelsConditioned pain modulationDiclofenacNeuropathicNSAIDOsteoarthritisPainQuantitative sensory testing

Identifiers

PMID27412526
PMCPMC4944243

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.