Osteoarthritis (OA) is progressive joint disease with an estimated global incidence of > 100 M. More than 50% of the population around the world (>65 years) show X-ray evidence of OA in at least one joint. Persons aged >65 years are more commonly affected by knee OA, and there is an alarming trend for future growth in the prevalence of knee OA. Moreover 80% of those with osteoarthritis will have limitations in movement, and 25% cannot perform their major daily activities of life. While the importance of exercise and physical therapy in the treatment of OA cannot be over emphasized, administration of pharmacologic treatments remain the mainstay of pain control. Various medical organizations all agree that these agents include acetominophen (paracetamol), NSAIDS, and opioids among others (especially for non-knee OA pain). However, a comparison of analgesics for osteoarthritis carried out by the Agency for Healthcare Research and Quality (a division of the U.S. Dept. of Health and Human Services) found that no currently available analgesic offers a clear overall advantage compared with the others. The unsatisfactory long-term efficacy and unacceptable side effects associated with traditional OA drugs has lead to a continued search for potential new medications.
According to the World Health Organization (WHO) projections the incidence of cancer will be >15 million in 2020. Moderate to severe pain in cancer is common and affects approximately 40% of all cancer patients and upwards of 70–80% of patients with advanced disease. Cancer pain control is problematic even with the currently available extremely potent opioid narcotics which have the burden of many and potentially severe side effects. Several studies have clearly demonstrated a direct inverse correlation between cancer pain intensity and quality of life which is reversible when cancer pain intensity is reduced. Satisfactory alleviation of cancer pain is difficult to achieve and several national and international associations are now recommending adding alternative pain management therapies such as meditation and cannabis. This complex phenomenon is associated with and dependent upon individual patient physiological and psychological characteristics, and disease/therapy history. Moreover, the etiologies of cancer pain are often multiple involving a mixture of nocioceptive, inflammatory, and neuropathic pain. For all these reasons, cancer pain therapy development programs are exceedingly complex. Our cancer pain clinical trial tool aims to increase the efficiency and accuracy of these development programs and therefore contribute to this important societal challenge.
A grant application is actually being under review by the Michael J. Fox Foundation.