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Measuring outcome in neuropathic pain trials

Dr. Nadine Attal from INSERM, discussed measurements in RCT’s of neuropathic pain and showed that there are great number of pain scales and questionnaires that have been used in clinical trials to assess the efficacy of interventions in neuropathic pain, varying from a simple visual analogue scale (VAS) or the numerical rating scale (NRS) to assess pain intensity to more complex multidimensional scales to assess pain, sleep, depression, quality or life or disability.NRS and VAS remain both the most suitable instruments to assess effects of treatment on pain intensity. Furthermore, clinical global impression of doctors (CGI) and responder rates are recommended for the assessment of overall change of neuropathic pain due to treatment.

These scales however, cannot capture dimensions of neuropathic pain experience such as burning pain, paroxysmal pain, shooting pain, etc. In addition to the NRS ,VAS, CGI and patient response rates, several neuropathic pain quality measures are suitable to discriminate between various pain mechanisms associated with the various dimensions of neuropathic pain experience.^[1]^[2] These scales are recommended by NeuPsig as secondary outcomes in neuropathic pain clinical trials.

Source:N. Attal. CLINICAL OUTCOME MEASURES IN NEUROPATHIC PAIN THERAPEUTIC TRIALS European Journal of Pain Supplements, Volume 4, Issue 1, May 2010, Page 12

Referenties

[1]: Gilron I, Attal N, Bouhassira D, Dworkin RH | Assessment of Neuropathic Pain (NP). In: Handbook of Pain Assessment, Turk D and Melzack R (editors) | Guilford Press, 3rnd edition, in press. | 2nd edition 2010

[2]: Haanpää ML, Backonja MM, Bennett MI, Bouhassira D, Cruccu G, Hansson PT, Jensen TS, Kauppila T, Rice AS, Smith BH, Treede RD, Baron R. | Assessment of neuropathic pain in primary care. | Am J Med. | 2009 Oct;122(10 Suppl):S13-21.