Response to Comment on: “Attempting to Separate Placebo Effects from Exercise in Chronic Pain: A Systematic Review and Meta-Analysis”

2021 ◽  
Author(s):  
Patrick J. Owen ◽  
Tobias Saueressig ◽  
Daniel L. Belavy ◽  
Christian A. Than ◽  
Jake Ball ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Placebo Effects

Attempting to Separate Placebo Effects from Exercise in Chronic Pain: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Clint T. Miller ◽  
Patrick J. Owen ◽  
Christian A. Than ◽  
Jake Ball ◽  
Kate Sadler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Placebo Effects

scholarly journals Comment on: “Attempting to Separate Placebo Effects from Exercise in Chronic Pain: A Systematic Review and Meta-analysis”

2021 ◽  
Author(s):  
Maximilian Koeppel ◽  
Stefan Peters ◽  
Gerhard Huber ◽  
Friederike Rosenberger ◽  
Joachim Wiskemann
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Placebo Effects

scholarly journals Correction to: Attempting to Separate Placebo Effects from Exercise in Chronic Pain: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Clint T. Miller ◽  
Patrick J. Owen ◽  
Christian A. Than ◽  
Jake Ball ◽  
Kate Sadler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Placebo Effects

679 Prevalence of Sleep Disturbances in Patients with Chronic Non-cancer Pain: A Systematic Review and Meta-Analysis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A265-A266
Author(s):  
Yishi Sun ◽  
Isabelle Laksono ◽  
Janannii Selvanathan ◽  
Aparna Saripella ◽  
Mahesh Nagappa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Cancer Pain ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Pain Group ◽  
Pooled Prevalence ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Introduction In individuals with chronic pain, sleep disturbances have been suggested to increase suffering, perception of pain, and to negatively affect long-term prognosis. This systematic review and meta-analysis aims to determine the pooled prevalence of sleep disturbances in chronic non-cancer pain patients with no other sleep disorders, using the patient-rated questionnaires Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Methods Multiple databases were searched for studies reporting the prevalence of sleep disturbances in chronic pain patients. Chronic pain was defined as pain >3 months. Comorbid sleep disorders such as sleep disordered breathing and restless leg syndrome were excluded. Sleep disturbances were defined using the PSQI cutoff of > 5 (poor sleep quality) and ISI ≥ 8 (subthreshold to clinical insomnia). The meta-analysis was conducted to examine the pooled prevalence of PSQI and ISI data using the inverse-variance random-effects model and to examine mean differences in PSQI scores. Results The systematic search resulted in 25,486 articles and 20 were included for analysis. In 12 studies using PSQI, the pooled prevalence of sleep disturbance was 75.3% among 3,597 chronic pain patients (mean age 53 ± 12 years; 74% female). In eight studies using ISI, the pooled prevalence was 72.9% among 2,578 chronic pain patients (mean age 63 ± 12 years; 57% female). The meta-analysis showed a significant mean difference of 2.75 (p < 0.001) in the global PSQI score between the chronic pain group versus the non-chronic pain group. The meta-analysis also showed a significant mean difference in the scores of four of seven PSQI components: sleep latency, sleep efficiency, sleep duration, and sleep disturbances (p < 0.05). Conclusion In chronic pain patients, the pooled prevalence of sleep disturbances as measured by PSQI (75.3%) and ISI (72.9%) studies was much higher than those reported for the general population. The relatively high prevalence of sleep disturbances in chronic pain patients emphasizes the importance of further characterizing the relationship between sleep and chronic pain. Support (if any):

scholarly journals Noninvasive brain stimulation combined with exercise in chronic pain: a systematic review and meta-analysis

2020 ◽  
Vol 20 (4) ◽  
pp. 401-412
Author(s):  
Alejandra Cardenas-Rojas ◽  
Kevin Pacheco-Barrios ◽  
Stefano Giannoni-Luza ◽  
Oscar Rivera-Torrejon ◽  
Felipe Fregni
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Noninvasive Brain Stimulation

scholarly journals P124 Are chronic pain syndromes associated with a unique cytokine profile? A systematic review and meta-analysis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Luke Furtado O'Mahony ◽  
Arnav Srivastava ◽  
Puja Mehta ◽  
Coziana Ciurtin
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cross Sectional ◽  
Pain Syndromes ◽  
Newcastle Ottawa Scale ◽  
Cytokine Milieu ◽  
Analysis Models ◽  
Chronic Pain Syndromes

Abstract Background/Aims  The aetiology of primary chronic pain syndromes (CPS) is highly disputed. One theory suggests that pain is due to a pro-inflammatory cytokine milieu leading to nociceptive activation. We performed a systematic review and meta-analysis aiming to assess differences in cytokines levels in CPS patients versus healthy controls (HC). Methods  Human studies published in English from PubMed, MEDLINE/Scopus and Cochrane databases were searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with cytokine measurements in CPS patients and HC. We excluded studies with underlying organic pathology. Quality assessment was completed using a modified version of the Newcastle-Ottawa Scale. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. Study registered with PROSPERO (CRD42020193774). Results  Initial search yielded 324 papers, 36 studies (3229 participants) eligible for systematic review and 26 studies (2048 participants) suitable for metaanalysis. There were reproducible findings supporting trends of cytokine levels comparing CPS patients with HC. Eotaxin (chemokine) however was consistently raised in CPS. Meta-analysis showed significantly increased tumour necrosis factor (TNF) (SMD=0.39, p = 0.0009, %95I=0.16-0.63, p < 0.001; I2=70%, Q2 p < 0.001), interleukin (IL)-6 (SMD=0.15, 8 (SMD=0.26, p = 0.01, 95%CI =0.05-0.47; I2=61%, Q2 p = 0.005) and IL-10 (SMD=0.61; %95 = 0.34-0.89, p < 0.001; I2 = 10%, Q2 p = 0.34) in CPS compared to HC. Conclusion  We found significant differences in peripheral blood cytokine profiles of CPS patients compared to HC. However, the distinctive profile associated with CPS includes both pro-inflammatory (TNF-α, IL-6, IL-8), and anti-inflammatory cytokines (IL-10) in pooled analysis, as well as chemokine (eotaxin) signatures. Disclosure  L. Furtado O'Mahony: None. A. Srivastava: None. P. Mehta: None. C. Ciurtin: None.

scholarly journals The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
pp. 205435812199399
Author(s):  
Sara N. Davison ◽  
Sarah Rathwell ◽  
Sunita Ghosh ◽  
Chelsy George ◽  
Ted Pfister ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Chronic Pain ◽  
Pain Management ◽  
Meta Analysis ◽  
Pain Severity ◽  
Chronic Pain Management ◽  
Dialysis Patients ◽  
Severity Scores ◽  
The Mean

Background: Chronic pain is a common and distressing symptom reported by patients with chronic kidney disease (CKD). Clinical practice and research in this area do not appear to be advancing sufficiently to address the issue of chronic pain management in patients with CKD. Objectives: To determine the prevalence and severity of chronic pain in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with glomerular filtration rate (GFR) category 3 to 5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of pain, and severity of pain. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library, last searched on February 3, 2020. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of overall chronic pain, musculoskeletal pain, bone/joint pain, muscle pain/soreness, and neuropathic pain and the I2 statistic was computed to measure heterogeneity. Random effects models were used to account for variations in study design and sample populations and a double arcsine transformation was used in the model calculations to account for potential overweighting of studies reporting either very high or very low prevalence measurements. Pain severity scores were calibrated to a score out of 10, to compare across studies. Weighted mean severity scores and 95% confidence intervals were reported. Results: Sixty-eight studies representing 16 558 patients from 26 countries were included. The mean prevalence of chronic pain in hemodialysis patients was 60.5%, and the mean prevalence of moderate or severe pain was 43.6%. Although limited, pain prevalence data for peritoneal dialysis patients (35.9%), those managed conservatively without dialysis (59.8%), those following withdrawal of dialysis (39.2%), and patients with earlier GFR category of CKD (61.2%) suggest similarly high prevalence rates. Limitations: Studies lacked a consistent approach to defining the chronicity and nature of pain. There was also variability in the measures used to determine pain severity, limiting the ability to compare findings across populations. Furthermore, most studies reported mean severity scores for the entire cohort, rather than reporting the prevalence (numerator and denominator) for each of the pain severity categories (mild, moderate, and severe). Mean severity scores for a population do not allow for “responder analyses” nor allow for an understanding of clinically relevant pain. Conclusions: Chronic pain is common and often severe across diverse CKD populations providing a strong imperative to establish chronic pain management as a clinical and research priority. Future research needs to move toward a better understanding of the determinants of chronic pain and to evaluating the effectiveness of pain management strategies with particular attention to the patient outcomes such as overall symptom burden, physical function, and quality of life. The current variability in the outcome measures used to assess pain limits the ability to pool data or make comparisons among studies, which will hinder future evaluations of the efficacy and effectiveness of treatments. Recommendations for measuring and reporting pain in future CKD studies are provided. Trial registration: PROSPERO Registration number CRD42020166965

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