INTERNATIONAL CRPS RESEARCH
Here is research from the University of Bath in UK. If you are :
a) between 14-25 years old with CRPS
b) OR a parent/caregiver of a young person ages 14-25 with CRPS, please take part in an online survey.
Please click below for more information.
(Received: May 17, 2018.)
Clinical Study of an injectable, low-dose combination product
for treatment of CRPS pain
(English long version)
Study Description and Intervention: Complex regional pain syndrome (CRPS) is a rare, severe post-traumatic pain condition affecting distal limbs. Patients who do not spontaneously improve within 12 months of onset, i.e., long-standing CRPS, have a poor prognosis and can often not be effectively treated. Preliminary clinical findings with GBM-5, a new investigational drug, have suggested that low-dose administration of GBM-5 might be an effective treatment for CRPS subjects, but further investigation is warranted.
As the clinical outcome has been shown to vary between CRPS subjects, the proposed trial protocol is tailored to treat the needs of patients individually. The study’s specific aims are:
1) to establish the safety and efficacy of an optimal dose regimen of GBM-5 in reducing long-standing pain in CRPS-I patients;
2) to preserve or restore function, enable patients to manage their condition and improve their quality of life (cognitive function, mood, depression, etc.); and
3) to assess whether patient-centered practice can improve health status and increase the overall quality of life. (Doctor-patient communication increases trust, adherence to treatment, and changes in pain medication use.)
Patient recruitment and care will be performed at the:
Montreal Pain Centre
529 Jarry Street East, Suite 400,
Phone: 438 386 7882
Fax: 438 386 1676
Gilbert Blaise, MD Principal Investigator
Clinic Staff left to right:
Seyed Mahdi Sedighi, MD, MA,Coordinator
Thierry Degreef, Participant and Patient
Dr. Gilbert Blaise, MD, Principal Investigator, Clinic Director
Daria Zaitseva, RN
Alireza Nekoui, MD, MSc., Researcher
Study status: Regulatory filing to Health Canada pending. In progress.
WOULD YOU LIKE TO CONTRIBUTE TO THIS RESEARCH?
Since PARC is a registered charity, we are able to issue tax receipts for donations of $20 and over.
For three ways to donate to this Canadian Research please see: Ways to Help page.
Be sure to specify that your donation is for "Canadian Research."
Clinical Study of an injectable, low-dose combination product
for treatment of CRPS pain
(English long version)
Background and Significance: While many chronic pain conditions are manageable, complex regional pain syndrome (CRPS) pain can be devastating, and it is one of the most challenging pain conditions in medicine. It is ranked as the most painful form of chronic pain that exists today by the McGill Pain Index and is characterized by severe pain-related changes (allodynia and hyperalgesia), trophic changes, neurovascular abnormalities (abnormal sweating, edema, and skin discoloration), motor changes (tremor, muscle spasm), and joint fibrosis and stiffness. CRPS results in loss of physical function, and can lead to significant and sometimes permanent disability. Additionally, CRPS subjects often experience cognitive changes, anxiety, and depression.
Despite the severe pain and disability associated with CRPS, the lack of understanding of the pathophysiological mechanisms supporting this enigmatic condition prevents the rational design of new therapies. Therefore, there is a clear demand for effective treatment options to address this important unmet medical need. Study of the disease has indicated that one single mechanism cannot account for all of the changes seen in subjects with CRPS and, consequently, a single ingredient medication is unlikely to be effective in this patient population.
After several years of research, the team at the Montreal Pain Clinic successfully formulated a combination product (namely GBM-5) which might address some underlying mechanisms thought to be involved in the pathophysiology of CRPS, such as neurogenic inflammation, sympathetic dysfunction, etc. This combination solution is a fixed multimodal formulation for intrathecal (IT) or epidural injection, which is clearly differentiated from other strong analgesics by its unique combined synergistic mechanism of action. Promising clinical experiences have been obtained in some of our clinic CRPS patients who had severe intractable pain. Further studies in more subjects are warranted.
Study Aims: As the clinical outcome has been shown to vary between CRPS subjects, the proposed trial protocol is tailored to treat the needs of patients individually. The study’s specific aims are:
Aim 1: To establish the safety and efficacy of an optimal dose regimen of GBM-5 in reducing long-standing pain in CRPS-I patients.
Aim 2: To preserve or restore function, enable patients to manage their condition and improve their quality of life (cognitive function, mood, depression, etc.).
Aim 3: To assess whether patient-centered practice will improve health status and increase the efficiency of care and overall quality of life.
It is hypothesized that low-dose intrathecal GBM-5 is safe and effective in long-standing CRPS subjects in reducing pain and/or concomitant systemic opioid use, and also improving the subject’s quality of life, independence, and capacity to work.
Study Description and Intervention: Complex regional pain syndrome (CRPS) is a rare, severe post-traumatic pain condition affecting distal limbs. Patients who do not spontaneously improve within 12 months of onset, i.e., long-standing CRPS, have a poor prognosis and can often not be effectively treated.
The purpose of this study will be to evaluate the efficacy of GBM-5 for the management of pain in CRPS-I subjects in an open-label study (subject end of study data will be compared to baseline). The project team will develop a multi-site, pragmatic trial where CRPS subjects will be enrolled to receive GBM-5, either intrathecally or epidurally, and the dose will be titrated until optimal pain reduction or reduction in opiate dose is achieved. The injection can be given every 3 days or weekly, depending on clinical outcome. Subjects can receive repeated treatment when pain returns.
Patient Population. Patients with confirmed CRPS-I of moderate to severe pain intensity are eligible. Main inclusion/exclusion criteria are:
Inclusion: Adults with a confirmed diagnosis of CRPS type I (Budapest Criteria) of at least one year’s duration and a pain severity score in the CRPS-affected limb of 4 or more on an 11-point scale (0-10) may participate after providing written informed consent.
Exclusion: Patients may not participate if they are or may become pregnant or are breastfeeding, have participated in another investigational drug trial within 3 months, have received a sympathetic nerve block within 3 weeks of treatment phase, or have any other clinically significant medical or pain condition.
Anticipated Impact: Projected patient outcomes:
Reduction of pain and/or concomitant systemic opioid use
Improvement of subject’s quality of life, independence, and capacity to work.
Patients in the collaborative care approach will have better-controlled pain, reduced depression, and better quality of life, satisfaction with care, adherence to treatments, and quality of care, as compared to those in the usual care approach.
Research environment: The Montreal Pain Clinic which is a division of Montreal Institute of Pain Management & Anti-Aging Medicine, under the direction of Dr. Gilbert Blaise, anesthesiologist and professor at the University of Montreal, is committed to patient-centered care, communication, clinical practice, and research in the area of pain management, especially in refractory chronic pain, including complex regional pain syndrome (CRPS). Primary goal is to deliver a suitable, long-lasting formulation that would decrease pain, improve cognitive function, and reduce opioid consumption and related side effects.
WOULD YOU LIKE TO CONTRIBUTE TO THIS RESEARCH?
Should you wish to donate to this research, you can donate online through Paypal. Please specify "Canadian Research" in the Special Instructions.
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For other ways to donate please see: Ways to Help page
CRPS RESEARCH IN BRITAIN (UK)
Take part in an online study looking at Complex Regional Pain Syndrome in young people and get an Amazon voucher!
Pain can present many challenges for young people and their families. These challenges can last a long time or may change over time. This study looks at the social developmental challenges that young people aged 14 to 25 who experience pain face. Adolescence is an important time of life for developing a sense of identity and future aspirations. This has been seen to be very important for well-being.
A team of researchers at the University of Bath in the UK are conducting research that addresses how young people with CRPS think about their future and how those around them (e.g. parents/caregivers) think about their child’s future.
If you are:
…then you may be eligible to take part in the study!
The study simply involves completing a 20-25 minute only survey which asks you to think about the future. Those who take part in the study will receive an electronic Amazon voucher to thank them for their time. Study recruitment is being conducted separately for both young people and parents. To find out more please visit https://wp.me/Pa4hqM-4 or to take part please email firstname.lastname@example.org
The study has been approved by the University of Bath Psychology Research Ethics Committee.
Survey is conducted under the direction of Dr. Abbie Jordan.
I KNOW WHAT YOU'RE THINKING;
WHY SHOULD I PARTICIPATE?
First of all, the research being conducted will help the researchers better understand the "puzzle of CRPS/RSD", what causes it, and how it works in the body.
Secondly, the scientific knowledge gained from these studies will lead to the development of better treatments for this painful, neurological syndrome.
New treatments are desperately needed for CRPS..
Thirdly, MOST IMPORTANTLY, CRPS patients living in Canada will benefit from Canadian research and treatments first.
Lastly, doing something NOW that will benefit you later, should be considered as a very good reason to help this excellent researcher gather his data.
PREVIOUS COMPLETED RESEARCH
Development of a perfusion MRI technique to investigate longitudinal effects of chronic pain on brain function
"The aim of this study is to find a tool for evaluation of treatment success in CRPS patients, Magnetic resonance imaging (MRI) is a diagnostic tool in medicine that generates high quality imaging of the human body without the use of x-rays. It can also provide information regarding how the brain functions, which is referred to as functional magnetic resonance imaging (fMRI). Changes in brain function during the course of treatment will be studied to investigate how such changes can reflect the success of treatment."
Research is done at Lawson Institute at St. Joe's Hospital in London Ontario. Participants will be reimbursed.
Mahsa Shokouhi PhD Principal Investigator
This research has been completed. Thanks to all who took part.
PARC helped with recruiting patients for this research.
We give special thanks to Masha Shokouhi PhD for
mentioning our contribution in her research paper.
"Defining Recovery from CRPS: a patients perspective"
McCabe CS RGN PhD et al
Royal Hospital for Rheumatic Diseases, Bath UK
UPDATE MAY 2017 : In July 2012, the CRPS Recovery Team met in Bath, UK to design a research paper on CRPS Recovery.The team consisted of doctors, researchers, scientists and patient research partners (PRPs) who continue to collaborate up to the present day. Our goal was to find out how and why patients recovered.
We used the Delphi method consisting of two rounds of questionnaires which formed the basis of the research. Questionnaires were "forward translated" into Dutch, Danish, Polish,German and several other languages for completion by patients in 8 countries. Responses were "back translated" into English. The basic question was "Are you recovered?" The second round of questionnaires recorded all responses and patients were asked to rank them in order of importance. Responses were rated in percentages.
PARC's Executive Director was honoured to be a member of this International CRPS Recovery team.
Dr. McCabe authored the first study and Alison Lewellyn PhD authored the second one. Both research papers have been published.
UPDATE MAY 2018: We are currently collaborating on another paper for the European Journal of Pain in 2017.
This paper was recently published in 2018.
Hamilton Inventory for CRPS.
PARC was pleased to sponsor our first local Canadian study!
Please note: this research below has been completed. Special thanks to all who participated.
Hamilton CRPS Research 2012-13
A research team from Hamilton Health Sciences and McMaster University are developing an assessment tool that is specific to complex regional pain syndrome. One part of the assessment was a questionnaire that asked the person to rate their own symptoms and the impact those symptoms had on their daily activities and relationships. We also interviewed people who have experienced CRPS to assist us in this process.
Tara Packham, OT Reg.(Ont), MSc
Hamilton Health Sciences
Dr. Joy MacDermid, PT, PhD
Physiotherapist and Associate Professor
School of Rehabilitation Sciences, McMaster University
[This work was conducted with support from PARC: Promoting Awareness of RSD/CRPS.]
Update October 2012
Brain changes in CRPS are becoming well known. The European Journal of Pain 2012 has recently published a study done by Jenny Lewis PhD of Bath, UK entitled "Body Perception Disturbance."
PARC was able to donate a further $5,000 to Mc Gill University to assist the NIRS studies at Montreal General Hospital. The NIRS machine (laser) will be travelling to San Diego, CA this winter to a busy pain clinic of CRPS patients at UCSD where space and research personnel have been donated. Many thanks to the dedicated Dr. Bennett who will travel and resume the study in California. PARC's contribution will help make this happen. Please read about the NIRS study below.
UPDATE APRIL 2010
Dr. Terrence Corderre (left) and Dr Gary Bennett (right), of Mc Gill University shown with the near-infrared spectrophotometer (NIRS) that was purchased with the help of PARC, Great West Life Assurance Company, and the family of Mr. Jeffrey Owens. The NIRS machine has the unique ability to measure blood flow and oxygenation in muscles non-invasively and painlessly via a laser light source and light sensor placed on the skin over the muscle. Drs. Bennett and Corderre are using the machine to test their theory that at least CRPS patients have pain due to an injury to the capillary blood vessels in a muscle.
PARC NOTE: With your help, PARC can continue to support the research of these excellent scientists at Mc Gill.
RESEARCH PAPERS BY DRS. BENNETT AND/OR CODERRE
"Objectifying CRPS": Coderre and Bennett
"Chronic Post-Ischemic Pain":
Coderre et al.pdf
This is only a partial list of research papers.
INTRODUCTION: DR. GARY BENNETT PhD
Gary J. Bennett, Ph.D., is Canada Senior Research Chair, Department of Anesthesia and Faculty of Dentistry, McGill University in Montreal, Canada. He earned his bachelor’s degree (Psychology) in 1970 from Rutgers University and his Ph.D. (Experimental Psychology) from the Medical College of Virginia, Virginia Commonwealth University in 1978. In the same year, he joined the Neurobiology and Anesthesiology Branch (NAB), National Institute of Dental Research, National Institutes of Health, as a Public Health Service Postdoctoral Fellow. He was appointed to the permanent staff of NAB in 1979, and was made Chief of the Neuropathic Pain and Pain Measurement Section in 1991. In 1996, he became Professor in the Department of Neurology at MCP Hahnemann University in Philadelphia. He joined McGill University in 2001.
He has served on the American Pain Society’s Board of Directors and on the Editorial Board for Pain (1986-1999), the journal of the International Association for the Study of Pain, and currently serves on the Editorial Board for Pain Medicine, the journal of the American Academy of Pain Medicine. He has served on the Board of Directors of the Reflex Sympathetic Dystrophy Syndrome Association of America, where he was Director of Research, and received their Scientific Achievement Award in 2000. He was awarded the American Pain Society’s Frederick W.L. Kerr Basic Science Research Award in 1996, and the American Academy of Pain Medicine’s Founder’s Award in 2001. For the past 25 years, his research has focused on the mechanisms underlying normal and abnormal pain sensations, and the pharmacological basis of pain control.
Dr.Bennett now resides in San Diego,USA and is CEO of Biointervene, a pharmaceutical preparations company. He is also Adjunct Professor at UCSD.
For further biography details please see International Research Consortium.
Click here to read a Q&A session with Dr. Gary J. Bennett, PhD from a November 2, 2016 chat presented by PARC in association with IRC (International Research Consortium) and RSDSA
UPDATE: APRIL 2010:
PARC was able to donate $10,000 towards CRPS research at Mc Gill. Please see the photo of Gary Bennett PhD for details.
UPDATE: December 2008
Due to the RIDE TO CONQUER CRPS 2008 and the fine efforts of Dr D.L. Shulman, PARC was able to donate $5,000 towards CRPS research. We urge all of you who are interested in finding a cure for CRPS, to support the research being done at McGill.
RESEARCH UPDATE: Aug. 22, 2008:
Dr G. Bennett,PhD, Sr. Research Chair, McGill University, and Montreal General Hospital will be holding a conference in conjunction with:
RIDE TO CONQUER CRPS 2008 on July 28.
JULY 28 details.
UPDATE: FEB 2007: Astra Zeneca has donated $2.5 million to a new lab at McGill University. Dr Magali Millecamps is the post doctoral fellow studying CRPS under the supervision of Dr Gary Bennett and Terry Cordere. Our hats are off to these dedicated researchers.
For more on McGill University please visit: McGill Pain Research
Complex Regional Pain Syndrome Type I (RSD):
New data from the clinic and the laboratory.
A Pain Forum presentation of the MUHC Pain Center
DATE: Monday, 28 July 2008
TIME: 1:00-4:30 PM
PLACE: Livingston Hall Lounge (Room L6-500)
Montreal General Hospital
1:00-1:05 Welcoming remarks (Gary J. Bennett, PhD; McGill University)
1:05-1:45 CRPS-I: The clinical picture. (David L. Shulman, MD CCFP FCFP DAAPM; Rothbart Pain Clinic, Toronto) RIDE TO CONQUER CRPS 2008 STOP
1:45 -2:45 A new theory: Deep tissue microvascular pathology as the cause of CRPS-I. (Terence J. Coderre, PhD; McGill University)
2:45-3:00 Health break
3:00-3:30 The role of the endothelins in CPIP pathology (Magali. Millecamps, PhD, McGill University)
3:30-4:00 CRPS-I breakthroughs: New data from Boston and Haifa (G. Bennett, PhD)
Many thanks to Gary Bennett PhD and colleagues for hosting the successful and very informative CRPS conference on July 28 at Montreal General Hospital.
Why is CRPS research important?!
BULLETIN: New research has found markers for CRPS. From Boston, a skin biopsy can now detect distal nerve damage. From Haifa Israel, a saliva test can measure high levels of LDH (lactate dehyrogenase), the same substance found in heart attack victims. It also found high levels of albumin.
DUTCH RESEARCH: In a database of 900,000 patients from 150 GPs in Holland, (specifically patients who attend a doctor), the rate of occurrence has been established as 26.2 in 100,000 patients.This is approximately 1 in every 4,000 people.
UPDATE 2017: For updated research projects at McGill University please follow this link:
McGill Pain Research