Fulranumab as Adjunctive Therapy for Cancer-Related Pain: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study.
Identifieur interne : 000492 ( Main/Exploration ); précédent : 000491; suivant : 000493Fulranumab as Adjunctive Therapy for Cancer-Related Pain: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study.
Auteurs : Neal Slatkin [États-Unis] ; Naim Zaki [États-Unis] ; Steven Wang [États-Unis] ; John Louie [États-Unis] ; Panna Sanga [États-Unis] ; Kathleen M. Kelly [États-Unis] ; John Thipphawong [États-Unis]Source :
- The journal of pain : official journal of the American Pain Society [ 1528-8447 ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Analgésiques morphiniques (administration et posologie), Analgésiques morphiniques (pharmacologie), Anticorps monoclonaux humanisés (administration et posologie), Anticorps monoclonaux humanisés (effets indésirables), Anticorps monoclonaux humanisés (pharmacologie), Association de médicaments (MeSH), Douleur cancéreuse (traitement médicamenteux), Facteurs immunologiques (administration et posologie), Facteurs immunologiques (effets indésirables), Facteurs immunologiques (pharmacologie), Femelle (MeSH), Gestion de la douleur (MeSH), Humains (MeSH), Injections sous-cutanées (MeSH), Mesure de la douleur (MeSH), Mâle (MeSH), Méthode en double aveugle (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Échec thérapeutique (MeSH), Études de suivi (MeSH).
- MESH :
- administration et posologie : Analgésiques morphiniques, Anticorps monoclonaux humanisés, Facteurs immunologiques.
- effets indésirables : Anticorps monoclonaux humanisés, Facteurs immunologiques.
- pharmacologie : Analgésiques morphiniques, Anticorps monoclonaux humanisés, Facteurs immunologiques.
- traitement médicamenteux : Douleur cancéreuse.
- Adulte, Adulte d'âge moyen, Association de médicaments, Femelle, Gestion de la douleur, Humains, Injections sous-cutanées, Mesure de la douleur, Mâle, Méthode en double aveugle, Sujet âgé, Sujet âgé de 80 ans ou plus, Échec thérapeutique, Études de suivi.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Analgesics, Opioid (administration & dosage), Analgesics, Opioid (pharmacology), Antibodies, Monoclonal, Humanized (administration & dosage), Antibodies, Monoclonal, Humanized (adverse effects), Antibodies, Monoclonal, Humanized (pharmacology), Cancer Pain (drug therapy), Double-Blind Method (MeSH), Drug Therapy, Combination (MeSH), Female (MeSH), Follow-Up Studies (MeSH), Humans (MeSH), Immunologic Factors (administration & dosage), Immunologic Factors (adverse effects), Immunologic Factors (pharmacology), Injections, Subcutaneous (MeSH), Male (MeSH), Middle Aged (MeSH), Outcome Assessment, Health Care (MeSH), Pain Management (MeSH), Pain Measurement (MeSH), Treatment Failure (MeSH).
- MESH :
- chemical , administration & dosage : Analgesics, Opioid, Antibodies, Monoclonal, Humanized, Immunologic Factors.
- chemical , adverse effects : Antibodies, Monoclonal, Humanized, Immunologic Factors.
- chemical , pharmacology : Analgesics, Opioid, Antibodies, Monoclonal, Humanized, Immunologic Factors.
- drug therapy : Cancer Pain.
- Adult, Aged, Aged, 80 and over, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Injections, Subcutaneous, Male, Middle Aged, Outcome Assessment, Health Care, Pain Management, Pain Measurement, Treatment Failure.
Abstract
This randomized, double-blind (DB), placebo-controlled, phase 2 study assessed the efficacy and safety of fulranumab as a pain therapy adjunctive to opioids in terminally ill cancer patients. Ninety-eight patients were randomized (2:1) to receive one subcutaneous injection of fulranumab (9 mg) or placebo in the 4-week DB phase. Seventy-one (72%) patients entered the 48-week open-label extension phase and were administered 9 mg of fulranumab every 4 weeks. The study failed to demonstrated efficacy at the end of the DB phase (primary endpoint, mean [SD] change in average cancer-related pain intensity was -.8 (1.26) for fulranumab and -.7 (1.56) for placebo; P = .592). However, potential benefit is suggested based on secondary endpoints (30% responder rate [P = .020], Brief Pain Inventory-Short Form [BPI-SF] pain intensity subscale [P = .003], and pain interference subscale [P = .006]). The most commonly reported treatment-emergent adverse events were (fulranumab vs placebo): asthenia (16% vs 10%), decreased appetite (12% vs 6%), fatigue (10% vs 0%), and malignant neoplasm progression (10% vs 0%). Although no differences were seen between fulranumab and placebo groups on the primary endpoint, improvements in BPI-SF pain subscale scores and responder rates support further research of anti-nerve growth factor therapy in cancer-related pain. PERSPECTIVE: Efficacy and safety of fulranumab as adjunctive pain therapy in terminally ill cancer patients were assessed. Results suggest that anti-NGF agents may prove to be novel additions in helping to optimize pain relief in cancer patients who fail to respond adequately to opioids and other common co-analgesics.
DOI: 10.1016/j.jpain.2018.09.014
PubMed: 30368018
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Analgesics, Opioid (administration & dosage)</term>
<term>Analgesics, Opioid (pharmacology)</term>
<term>Antibodies, Monoclonal, Humanized (administration & dosage)</term>
<term>Antibodies, Monoclonal, Humanized (adverse effects)</term>
<term>Antibodies, Monoclonal, Humanized (pharmacology)</term>
<term>Cancer Pain (drug therapy)</term>
<term>Double-Blind Method (MeSH)</term>
<term>Drug Therapy, Combination (MeSH)</term>
<term>Female (MeSH)</term>
<term>Follow-Up Studies (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Immunologic Factors (administration & dosage)</term>
<term>Immunologic Factors (adverse effects)</term>
<term>Immunologic Factors (pharmacology)</term>
<term>Injections, Subcutaneous (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Outcome Assessment, Health Care (MeSH)</term>
<term>Pain Management (MeSH)</term>
<term>Pain Measurement (MeSH)</term>
<term>Treatment Failure (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Analgésiques morphiniques (administration et posologie)</term>
<term>Analgésiques morphiniques (pharmacologie)</term>
<term>Anticorps monoclonaux humanisés (administration et posologie)</term>
<term>Anticorps monoclonaux humanisés (effets indésirables)</term>
<term>Anticorps monoclonaux humanisés (pharmacologie)</term>
<term>Association de médicaments (MeSH)</term>
<term>Douleur cancéreuse (traitement médicamenteux)</term>
<term>Facteurs immunologiques (administration et posologie)</term>
<term>Facteurs immunologiques (effets indésirables)</term>
<term>Facteurs immunologiques (pharmacologie)</term>
<term>Femelle (MeSH)</term>
<term>Gestion de la douleur (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Injections sous-cutanées (MeSH)</term>
<term>Mesure de la douleur (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Méthode en double aveugle (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Échec thérapeutique (MeSH)</term>
<term>Études de suivi (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Analgesics, Opioid</term>
<term>Antibodies, Monoclonal, Humanized</term>
<term>Immunologic Factors</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term>
<term>Immunologic Factors</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Analgesics, Opioid</term>
<term>Antibodies, Monoclonal, Humanized</term>
<term>Immunologic Factors</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Analgésiques morphiniques</term>
<term>Anticorps monoclonaux humanisés</term>
<term>Facteurs immunologiques</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Cancer Pain</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term>
<term>Facteurs immunologiques</term>
</keywords>
<keywords scheme="MESH" qualifier="pharmacologie" xml:lang="fr"><term>Analgésiques morphiniques</term>
<term>Anticorps monoclonaux humanisés</term>
<term>Facteurs immunologiques</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Douleur cancéreuse</term>
</keywords>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Double-Blind Method</term>
<term>Drug Therapy, Combination</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Injections, Subcutaneous</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Outcome Assessment, Health Care</term>
<term>Pain Management</term>
<term>Pain Measurement</term>
<term>Treatment Failure</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Association de médicaments</term>
<term>Femelle</term>
<term>Gestion de la douleur</term>
<term>Humains</term>
<term>Injections sous-cutanées</term>
<term>Mesure de la douleur</term>
<term>Mâle</term>
<term>Méthode en double aveugle</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
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<front><div type="abstract" xml:lang="en">This randomized, double-blind (DB), placebo-controlled, phase 2 study assessed the efficacy and safety of fulranumab as a pain therapy adjunctive to opioids in terminally ill cancer patients. Ninety-eight patients were randomized (2:1) to receive one subcutaneous injection of fulranumab (9 mg) or placebo in the 4-week DB phase. Seventy-one (72%) patients entered the 48-week open-label extension phase and were administered 9 mg of fulranumab every 4 weeks. The study failed to demonstrated efficacy at the end of the DB phase (primary endpoint, mean [SD] change in average cancer-related pain intensity was -.8 (1.26) for fulranumab and -.7 (1.56) for placebo; P = .592). However, potential benefit is suggested based on secondary endpoints (30% responder rate [P = .020], Brief Pain Inventory-Short Form [BPI-SF] pain intensity subscale [P = .003], and pain interference subscale [P = .006]). The most commonly reported treatment-emergent adverse events were (fulranumab vs placebo): asthenia (16% vs 10%), decreased appetite (12% vs 6%), fatigue (10% vs 0%), and malignant neoplasm progression (10% vs 0%). Although no differences were seen between fulranumab and placebo groups on the primary endpoint, improvements in BPI-SF pain subscale scores and responder rates support further research of anti-nerve growth factor therapy in cancer-related pain. PERSPECTIVE: Efficacy and safety of fulranumab as adjunctive pain therapy in terminally ill cancer patients were assessed. Results suggest that anti-NGF agents may prove to be novel additions in helping to optimize pain relief in cancer patients who fail to respond adequately to opioids and other common co-analgesics.</div>
</front>
</TEI>
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<DateCompleted><Year>2020</Year>
<Month>08</Month>
<Day>10</Day>
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<DateRevised><Year>2020</Year>
<Month>08</Month>
<Day>10</Day>
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<JournalIssue CitedMedium="Internet"><Volume>20</Volume>
<Issue>4</Issue>
<PubDate><Year>2019</Year>
<Month>04</Month>
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<Title>The journal of pain : official journal of the American Pain Society</Title>
<ISOAbbreviation>J Pain</ISOAbbreviation>
</Journal>
<ArticleTitle>Fulranumab as Adjunctive Therapy for Cancer-Related Pain: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study.</ArticleTitle>
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<Abstract><AbstractText>This randomized, double-blind (DB), placebo-controlled, phase 2 study assessed the efficacy and safety of fulranumab as a pain therapy adjunctive to opioids in terminally ill cancer patients. Ninety-eight patients were randomized (2:1) to receive one subcutaneous injection of fulranumab (9 mg) or placebo in the 4-week DB phase. Seventy-one (72%) patients entered the 48-week open-label extension phase and were administered 9 mg of fulranumab every 4 weeks. The study failed to demonstrated efficacy at the end of the DB phase (primary endpoint, mean [SD] change in average cancer-related pain intensity was -.8 (1.26) for fulranumab and -.7 (1.56) for placebo; P = .592). However, potential benefit is suggested based on secondary endpoints (30% responder rate [P = .020], Brief Pain Inventory-Short Form [BPI-SF] pain intensity subscale [P = .003], and pain interference subscale [P = .006]). The most commonly reported treatment-emergent adverse events were (fulranumab vs placebo): asthenia (16% vs 10%), decreased appetite (12% vs 6%), fatigue (10% vs 0%), and malignant neoplasm progression (10% vs 0%). Although no differences were seen between fulranumab and placebo groups on the primary endpoint, improvements in BPI-SF pain subscale scores and responder rates support further research of anti-nerve growth factor therapy in cancer-related pain. PERSPECTIVE: Efficacy and safety of fulranumab as adjunctive pain therapy in terminally ill cancer patients were assessed. Results suggest that anti-NGF agents may prove to be novel additions in helping to optimize pain relief in cancer patients who fail to respond adequately to opioids and other common co-analgesics.</AbstractText>
<CopyrightInformation>Copyright © 2019. Published by Elsevier Inc.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Slatkin</LastName>
<ForeName>Neal</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>School of Medicine, University of California - Riverside, California. Electronic address: neal.slatkin@salix.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zaki</LastName>
<ForeName>Naim</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Janssen Research & Development, LLC, Titusville, New Jersey.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wang</LastName>
<ForeName>Steven</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Janssen Research & Development, LLC, Titusville, New Jersey.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Louie</LastName>
<ForeName>John</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Janssen Research & Development, LLC, Fremont, California.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sanga</LastName>
<ForeName>Panna</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Janssen Research & Development, LLC, Titusville, New Jersey.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kelly</LastName>
<ForeName>Kathleen M</ForeName>
<Initials>KM</Initials>
<AffiliationInfo><Affiliation>Janssen Research & Development, LLC, Titusville, New Jersey.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Thipphawong</LastName>
<ForeName>John</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Janssen Research & Development, LLC, Fremont, California.</Affiliation>
</AffiliationInfo>
</Author>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D017427">Clinical Trial, Phase II</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D016449">Randomized Controlled Trial</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2018</Year>
<Month>10</Month>
<Day>25</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>J Pain</MedlineTA>
<NlmUniqueID>100898657</NlmUniqueID>
<ISSNLinking>1526-5900</ISSNLinking>
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<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000701">Analgesics, Opioid</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D061067">Antibodies, Monoclonal, Humanized</NameOfSubstance>
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<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007155">Immunologic Factors</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0E986JU40I</RegistryNumber>
<NameOfSubstance UI="C000592179">fulranumab</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000701" MajorTopicYN="N">Analgesics, Opioid</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
<QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D061067" MajorTopicYN="N">Antibodies, Monoclonal, Humanized</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000072716" MajorTopicYN="N">Cancer Pain</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004311" MajorTopicYN="N">Double-Blind Method</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007155" MajorTopicYN="N">Immunologic Factors</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007279" MajorTopicYN="N">Injections, Subcutaneous</DescriptorName>
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<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
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<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017063" MajorTopicYN="Y">Outcome Assessment, Health Care</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D059408" MajorTopicYN="Y">Pain Management</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010147" MajorTopicYN="N">Pain Measurement</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017211" MajorTopicYN="N">Treatment Failure</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Anti-NGF antibodies</Keyword>
<Keyword MajorTopicYN="Y">cancer</Keyword>
<Keyword MajorTopicYN="Y">cancer-related pain</Keyword>
<Keyword MajorTopicYN="Y">fulranumab</Keyword>
<Keyword MajorTopicYN="Y">nerve growth factor</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year>
<Month>07</Month>
<Day>09</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2018</Year>
<Month>09</Month>
<Day>20</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2018</Year>
<Month>09</Month>
<Day>28</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2018</Year>
<Month>10</Month>
<Day>28</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2020</Year>
<Month>8</Month>
<Day>11</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2018</Year>
<Month>10</Month>
<Day>28</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">30368018</ArticleId>
<ArticleId IdType="pii">S1526-5900(18)30739-9</ArticleId>
<ArticleId IdType="doi">10.1016/j.jpain.2018.09.014</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
<li>New Jersey</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Californie"><name sortKey="Slatkin, Neal" sort="Slatkin, Neal" uniqKey="Slatkin N" first="Neal" last="Slatkin">Neal Slatkin</name>
</region>
<name sortKey="Kelly, Kathleen M" sort="Kelly, Kathleen M" uniqKey="Kelly K" first="Kathleen M" last="Kelly">Kathleen M. Kelly</name>
<name sortKey="Louie, John" sort="Louie, John" uniqKey="Louie J" first="John" last="Louie">John Louie</name>
<name sortKey="Sanga, Panna" sort="Sanga, Panna" uniqKey="Sanga P" first="Panna" last="Sanga">Panna Sanga</name>
<name sortKey="Thipphawong, John" sort="Thipphawong, John" uniqKey="Thipphawong J" first="John" last="Thipphawong">John Thipphawong</name>
<name sortKey="Wang, Steven" sort="Wang, Steven" uniqKey="Wang S" first="Steven" last="Wang">Steven Wang</name>
<name sortKey="Zaki, Naim" sort="Zaki, Naim" uniqKey="Zaki N" first="Naim" last="Zaki">Naim Zaki</name>
</country>
</tree>
</affiliations>
</record>
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