Personalized treatment of neuropathic pain: Where are we now?

Abstract

Background: The treatment of neuropathic pain remains a major unmet need that the development of personalized and refined treatment strategies may contribute to address. Database: In this narrative review, we summarize the various approaches based on objective biomarkers or clinical markers that could be used. Results: In principle, the validation of objective biomarkers would be the most robust approach. However, although promising results have been reported demonstrating a potential value of genomics, anatomical or functional markers, the clinical validation of these markers has only just begun. Thus, most of the strategies documented to date have been based on the development of clinical markers. In particular, many studies have suggested that the identification of specific subgroups of patients presenting with specific combinations of symptoms and signs would be a relevant approach. Two main approaches have been used to identify relevant sensory profiles: quantitative sensory testing and specific patients reported outcomes based on description of pain qualities. Conclusion: We discuss here the advantages and limitations of these approaches, which are not mutually exclusive. Significance: Recent data indicate that various new treatment strategies based on predictive biological and/or clinical markers could be helpful to better personalized and therefore improve the management of neuropathic pain.