Article - Pain Recommendations Aim to Help Millions of Americans Who Experience Neuropathic Pain

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Pain Recommendations Aim to Help Millions of Americans Who Experience

Neuropathic Pain

CHADDS FORD, PA -- November 19, 2003 -- First-of-a-kind pain guidelines,

developed by leading international experts in pain management, are published

in this month's issue of Archives of Neurology. The evidence-based

guidelines are designed to help physicians better diagnose and manage

patients suffering from chronic neuropathic pain.

" Neuropathic pain is defined as pain caused by a lesion or dysfunction to

the peripheral or central nervous system, " said H. Dworkin, Ph.D.,

professor of anesthesiology, neurology, oncology, and psychiatry, director,

Anesthesiology Clinical Research Center at the University of Rochester

School of Medicine and Dentistry and lead author of the guidelines. " If not

treated, pain can have significant physical, psychological and financial

consequences by affecting daily functioning and quality of life. These

guidelines are significant because they review recent randomized controlled

trials, provide physicians with recommendations on specific therapies as

first-line treatment, and offer information regarding side effects,

titration, target dosages, and other issues involved in their use. "

The new guidelines offer recommendations for first-line pharmacologic

treatments based on results from multiple, randomized controlled studies,

impact on quality of life, and costs of treatment. Therapies recommended by

these international experts as first-line agents for the treatment of the

neuropathic pain include lidocaine patch 5%, gabapentin, opioid analgesics,

tramadol, and tricyclic antidepressants. Lidoderm® (lidocaine patch 5%), a

topical treatment that targets the site of the pain, rather than the entire

body, was the first FDA-approved drug for postherpetic neuralgia (PHN), a

form of neuropathic pain and is the only topical treatment recommended as a

first-line therapy in these guidelines.

" The challenge with neuropathic pain is that no single symptom points to the

condition, thus making diagnosis difficult, " said E. Argoff, M.D.,

director of the Cohn Pain Management Center and an assistant professor of

neurology at New York University School of Medicine and a co-author of the

guidelines. " According to an American Pain Society study, only one in four

patients with chronic pain receives adequate treatment, and my hope is that

these guidelines will translate into improved diagnosis and treatment for

patients, many of whom have put their lives on hold due to their chronic

pain. "

The treatment guidelines were made possible by an unrestricted educational

grant from Endo Pharmaceuticals to the University of Rochester Office of

Professional Education.

Approximately one million U.S. patients contract shingles (varicella zoster

virus) each year and, of these, 20 percent will suffer from postherpetic

neuralgia (PHN), a painful, often excruciating pain condition that can

persist for months or even years where the shingles eruption occurred. For

some patients, the neuropathic pain of PHN can lead to serious debilitation.

About Lidoderm®

Lidoderm® (lidocaine patch 5%) is FDA-approved for the relief of pain

associated with postherpetic neuralgia (PHN). The Lidoderm® patch produces

an analgesic effect by the penetration of lidocaine from the patch into the

epidermal and dermal layers of the skin, without loss of sensation or

numbness. Lidoderm® should only be applied to intact skin. Reactions to the

Lidoderm® patch are generally mild and transient. During or immediately

after treatment with Lidoderm®, the skin at the site of treatment may

develop erythema or edema. The Lidoderm® patch is contraindicated in

patients with a known history of sensitivity to local anesthetics of the

amide type, or to any other component product.

The FDA-approved dosing for the Lidoderm® patch is up to three patches

applied for up to 12 hours within a 24-hour period. The Lidoderm® patch has

not been approved by the FDA for any indications other than for the relief

of pain associated with PHN, and its safety and efficacy in other

indications have not been established.

SOURCE: Endo Pharmaceuticals