Evidence map›Paper›PMID 29258584›Full record

Trial reportTrials2017

Lymphocyte opioid receptors as innovative biomarkers of osteoarthritic pain, for the assessment and risk management of opioid tailored therapy, before hip surgery, to prevent chronic pain and opioid tolerance/addiction development: OpMarkArt (Opioids-Markers-Arthroprosthesis) study protocol for a randomized controlled trial.

Valentina Malafoglia, Monica Celi, Carolina Muscoli, Sara Ilari, Filomena Lauro, Luigino Antonio Giancotti, Chiara Morabito, Maurizio Feola, Umberto Tarantino, William Raffaeli

Open access · goldAbstract readClinical Trial, Phase IVRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. The Interplay between Chronic Pain, Opioids, and the Immune System.The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry · 2022
    Review
  3. Review
  4. Expression of Opioid Receptors in Cells of the Immune System.International journal of molecular sciences · 2020
    Review
  5. Article
  6. Observational
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

10 authors at 4 institutions in 1 country.

Valentina MalafogliaInstitute for Research on Pain, ISAL Foundation, Torre Pedrera, RN, Italy. valentinamalafoglia@yahoo.it.ORCID http://orcid.org/0000-0002-1533-704X
Monica CeliPoliclinico Foundation Tor Vergata, University of Tor Vergata, Rome, Italy.
Carolina MuscoliInstitute of Research for Food Safety & Health (IRC_FSH), Department of Health Sciences, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy.
Sara IlariSan Raffaele Roma S.r.l., Roccelletta di Borgia, Catanzaro, Italy.
Filomena LauroSan Raffaele Roma S.r.l., Roccelletta di Borgia, Catanzaro, Italy.
Luigino Antonio GiancottiSan Raffaele Roma S.r.l., Roccelletta di Borgia, Catanzaro, Italy.
Chiara MorabitoDepartment of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy.
Maurizio FeolaPoliclinico Foundation Tor Vergata, University of Tor Vergata, Rome, Italy.
Umberto TarantinoPoliclinico Foundation Tor Vergata, University of Tor Vergata, Rome, Italy.
William RaffaeliInstitute for Research on Pain, ISAL Foundation, Torre Pedrera, RN, Italy.
Policlinico Tor Vergata · ITFondazione ISAL · ITMagna Graecia University · ITSapienza University of Rome · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe incidence of post-surgical chronic pain ranges between 20% and 40% in Europe. Osteoarthritis pain after prosthesis implantation is one of the most severe secondary syndromes, depending not only on surgery but also on organic changes before and after joints replacement. No data are available about risk factors. An excessive inflammatory response plays a central role but a best therapy is not defined yet. It is not clear whether opioid administration could influence post-surgical pain and lead to tolerance or addiction. Interestingly, the immune system, together with the nervous and peptidergic ones, is involved in hypersensibility. The connection across the three biological systems lies in the presence of opioid receptors on immune cells surface. Here, we show a method to analyze whether opioids could modulate lymphocytes, by proposing opioid receptors as biological markers to prevent chronic pain and opioid tolerance or addiction after hip surgery. METHODS/

designAfter institutional independent ethics committee approval, 60 patients, in pain and undergoing hip surgery, will be enrolled in a single-blind, randomized, phase IV, pilot study. Pain treatment will be selected inside a class of non-steroidal anti-inflammatory drugs (NAISDs) or paracetamol or a class of opioids, into three medication arms: 25 mg tapentadol twice daily; 75 mg tapentadol twice daily; NSAIDs or paracetamol in accordance with surgeon's custom. For each group, we will collect blood samples before, during and after surgery, to apply molecular analysis. We will perform lymphocyte opioid receptors genes and proteins expression and functional analysis. Data will be statistically analyzed. DISCUSSION: This project has the potential to obtain a personalized diagnostic kit, by considering lymphocyte opioid receptors as biological markers. Starting from a simple blood sample, it will be possible to decide the best therapy for a single patient. Using a noninvasive approach, we expect to fix a daily standard dose and timing, before and after surgery, to bypass hip chronic pain and the insurgence of tolerance or addiction. The analysis of opioid receptors sensitivity will help to identify the best drug administration in each specific case (tailored therapy).

trial registrationISRCTN, ISRCTN12559751 . Retrospectively registered on 23 May 2017.

Indexed as

Drug ToleranceAnalgesics, OpioidArthralgiaArthroplasty, Replacement, HipBiomarkersChronic PainClinical ProtocolsHumansLymphocytesOpioid-Related DisordersOsteoarthritis, HipPain MeasurementPilot ProjectsPostoperative PainReceptors, OpioidResearch DesignAnalgesics, OpioidBiomarkersReceptors, OpioidAddictionArthroprosthesisBiological markersChronic painHip surgeryLymphocytesOpioid receptorsOpioidsTailored therapyTolerance

Identifiers

PMID29258584
PMCPMC5738165
OpenAlexW2780171855

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.