Determining the appropriate pharmacotherapy for pain in patients with amyotrophic lateral sclerosis: A multicenter prospective observational study

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K15501
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Medical pharmacy
• Research Institution: Kanazawa University
• Principal Investigator: Ishida Natsuko 金沢大学, 薬学系, 助教 (70794220)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 筋萎縮性側索硬化症 / 疼痛緩和 / 緩和ケア / QOL

Outline of Final Research Achievements

This study aimed to establish the pharmacotherapy for treating pain in patients with amyotrophic lateral sclerosis (ALS), tailored according to the cause of pain and extent of illness. In this multicenter cross-sectional study, youth, bedridden state, and limb onset were significantly related to pain in ALS. During the observational period in the multicenter prospective study, the group that did not experience pain reported a decline in physical function, whereas no change was observed in the physical function of the group that experienced pain. These results suggest that ALS patients with unchanged body function were particularly prone to pain. Moreover, analgesic adjuvants and opioids should be used aggressively because many patients using only non-steroidal anti-inflammatory drugs complained of pain.

Free Research Field

医療薬学

Academic Significance and Societal Importance of the Research Achievements

本研究によりALS患者の疼痛は疾患の進行に伴うものではなく，むしろ身体機能の維持された状況で発現しやすいことが示唆された。このことから，ALS患者においては発症早期から定期的に疼痛評価を行うことが必要であると考える。さらに，疼痛を緩和するためにはNSAIDｓだけではなくオピオイドや鎮痛補助薬などを使用することが必要であると示唆された。本研究で得られた知見がALS患者の疼痛の緩和，さらにはQOLの向上に資することが期待される。