Impact of Chronobiology on Neuropathic Pain Treatment

Abstract

Inflammatory pain exhibits circadian rhythmicity. Recently, a distinct diurnal pattern has been described for peripheral neuropathic conditions. This diurnal variation has several implications: advancing understanding of chronobiology may facilitate identification of new and improved treatments; developing pain-contingent strategies that maximize treatment at times of the day associated with highest pain intensity may provide optimal pain relief as well as minimize treatment-related adverse effects (e.g., daytime cognitive dysfunction); and consideration of the impact of chronobiology on pain measurement may lead to improvements in analgesic study design that will maximize assay sensitivity of clinical trials. Recent and ongoing chronobiology studies are thus expected to advance knowledge and treatment of neuropathic pain.

KEYWORDS:

• circadian rhythms
• clinical trials
• diurnal variation
• neuropathic pain
• nocturnal pain

Financial & competing interests disclosure

I Gilron has received support from Adynxx, Taris Biomedical, AstraZeneca, Pfizer and Johnson & Johnson; and has received grants from the Canadian Institutes of Health Research, Physicians’ Services Incorporated Foundation and Queen’s University. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

I Gilron has received support from Adynxx, Taris Biomedical, AstraZeneca, Pfizer and Johnson & Johnson; and has received grants from the Canadian Institutes of Health Research, Physicians’ Services Incorporated Foundation and Queen’s University. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.