Globally, there is a cultural movement to diminish the use of opioids which has left, in many cases, few options for those on chronic opioid therapy. Currently there are more than 12 million Americans who receive some form of chronic opioid therapy.
Scientists are only now beginning to examine the genetic variations that may influence pain processing. If a genetic basis underlies how pain is expressed and perceived, including the varying mechanisms of nociceptive, neuropathic, and visceral pain, then the potential exists for new analgesic targets affecting such gene products. Andrew Purchase explains:
Andrew Purchase will be speaking at the World Drug Safety Congress Americas on April 10, 2018 on "The adoption of pharmacogenomics leading to patient benefit."
Pharmacogenomics (the entire genome) has emerged as an important discipline in the evaluation, safety, and efficacy of treatments used. The use of genomic data, biomarkers and associated technology, and the concept of “personalized” treatment have received increased attention in recent years. This is governed by the growing understanding of the inter-individual differences in DNA sequences as well as the ability to link a particular drug response to variations in the human genome.
Pharmacogenetics therapy in pain requires consideration of two different genetic substrates to determine the outcome of pharmacotherapy. The first is the genetic contribution of the variety of different pain types, and the second is the genetic influence of drug effectiveness and safety. Recent findings for pain pharmacogenomics have indicated variability in responses from multiple genes and that differences in the efficacy of analgesic drugs are genetically controlled. Pharmacogenomics can help to identify individuals who are at risk of poorly responding to pain medicine and those who might be more susceptible to adverse drug effects.
In the US alone there are estimated to be around 100 million adults suffering with some type of chronic pain. Around 80% of people undergoing surgeries report some degree of post-operative pain. Within that pool, less than 50% feel they received adequate pain relief and between 10-50% developed some type of chronic pain. The estimated annual national economic cost of pain management is around $560-635 million.
Each individual carries their own genetic imprint for the risk of severe or chronic pain and their response to pain treatment. Progress in genetic research and pharmacogenomics can help to uncover gene and associated interactions that influence pain perception and treatment pathways among the most painful diseases. Continued advances, investment, and genome associated studies are needed to further complete the genetic puzzle and to identify full genetic signatures for pain and pain treatment in order to help genetic testing become a widespread part of clinical practice.