Terapi Farmakologi Nyeri pada Amyotrophic Lateral Sclerosis
Abstract
Amyotrophic lateral sclerosis (ALS) merupakan penyakit neurodegeneratif fatal yang memengaruhi motor neuron. Nyeri merupakan gangguan sensoris yang dapat timbul pada ALS dan gejala yang seringkali diremehkan dan diabaikan pada pasien dengan ALS. Sampai saat ini, terapi nyeri hanya didasarkan pada pengalaman klinisi dan belum terdapat tata laksana nyeri yang terstandarisasi untuk pasien ALS. Oleh karena itu, tinjauan pustaka ini bertujuan untuk membahas gambaran klinis dan tata laksana nyeri pada ALS. Penelusuran referensi dilakukan melalui database PubMed dan Google Scholar dengan menggunakan kata kunci “Amyotrophic Lateral Sclerosis”, “pain”, “pharmacology”, dan “therapy”. Hasil penelusuran menunjukkan bahwa terdapat beberapa gambaran klinis nyeri pada ALS, seperti kram, spastisitas dan nyeri muskuloskeletal, sehingga tata laksana nyeri pada ALS harus didasarkan pada penyebab utama timbulnya nyeri. Terbatasnya evidence terkait terapi nyeri pada ALS menyebabkan pemberian terapi tidak dilakukan berdasarkan pendekatan sistematis, sehingga dibutuhkan studi lebih lanjut terkait efikasi dari terapi nyeri ALS.
Kata kunci: Amyotrophic lateral sclerosis, farmakologi, nyeri, terapi
Pharmacology Therapy for Pain in Amyotrophic Lateral Sclerosis
Abstract
The cause of motor neurons is amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease with the potential to cause a frequently ignored sensory disorder called pain. Furthermore, pain therapy today is usually based on the clinician’s experience while standardized pain management for ALS patients is unused. Therefore, this literature review aimed to explore ALS clinical features and pain management. The database investigation was performed on PubMed and Google Scholar using the keywords “Amyotrophic Lateral Sclerosis”, “pain”, “pharmacology”, and “therapy”. The results showed the presence of several pain clinical features in ALS, including cramps, spasticity and musculoskeletal pain, and therefore the need for ALS pain supervision to be based on the major cause. However, there were limited evidence reported investigating the effectiveness of drug therapy for this pain, and further research is required to discover efficient and safe pain treatment agents.
Keywords: Amyotrophic lateral sclerosis, pain, pharmacology, therapy
Keywords
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Brettschneider J, Kurent J, Ludolph A. Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database of Systematic Reviews. 2013; 6.
Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, et al. A comprehensive review of amyotrophic lateral sclerosis. Surg Neurol Int. 2015;6(1):171–94.
Delpont B, Beauvais K, Jacquin-Piques A, Alavoine V, Rault P, Blanc-Labarre C, et al. Clinical features of pain in amyotrophic lateral sclerosis: A clinical challenge. Rev Neurol (Paris). 2019;175(1–2):11–5.
Yunusova Y, Plowman EK, Green JR, Barnett C, Bede P. Clinical measures of bulbar dysfunction in ALS. Front Neurol. 2019;10(106).
Pizzimenti A, Aragona M, Onesti E, Inghilleri M. Depression, Pain and Quality of Life in Patients with Amyotrophic Lateral Sclerosis: A Cross Sectional Study. Funct Neurol. 2013;28(2):115–9.
Paganoni S, Karam C, Joyce N, Carter GT, Hospital R, Hospital MG, et al. Comprehensive Rehabilitative Care Across the Spectrum of Amyotrophic Lateral Sclerosis. NeuroRehabilitation. 2017;37(1):53–68.
Chiò A, Mora G, Lauria G. Pain in amyotrophic lateral sclerosis. Lancet Neurol. 2017;16(2):144–57.
Oskarsson B, Gendron TF, Staff NP. Amyotrophic Lateral Sclerosis: An Update for 2018. Mayo Clin Proc [Internet]. 2018;93(11):1617–28. Available from: https://doi.org/10.1016/j.mayocp.2018.04.007
Hanisch F, Skudlarek A, Berndt J, Kornhuber ME. Characteristics of pain in amyotrophic lateral sclerosis. Brain Behav. 2015;5(3):8–19.
Yam MF, Loh YC, Tan CS, Adam SK, Manan NA, Basir R. General pathways of pain sensation and the major neurotransmitters involved in pain regulation. Int J Mol Sci. 2018;19(8).
Rivera I, Ajroud-Driss S, Casey P, Heller S, Allen J, Siddique T, et al. Prevalence and characteristics of pain in early and late stages of ALS. Amyotroph Lateral Scler Front Degener. 2013;14(5–6):369–72.
Stephens HE, Lehman E, Raheja D, Yang C, Walsh S, Mcarthur DB, et al. Pain in amyotrophic lateral sclerosis: Patient and physician perspectives and practices. Amyotroph Lateral Scler Front Degener. 2016;17(1–2):21–9.
Åkerblom Y, Jakobsson Larsson B, Zetterberg L, Åsenlöf P. The multiple faces of pain in motor neuron disease: a qualitative study to inform pain assessment and pain management. Disabil Rehabil [Internet]. 2019;0(0):1–10. Available from: https://doi.org/10.1080/09638288.2018.1555615
Wallace VCJ, Ellis CM, Burman R, Knights C, Shaw CE, Al-Chalabi A. The evaluation of pain in amyotrophic lateral sclerosis: A case controlled observational study. Amyotroph Lateral Scler Front Degener [Internet]. 2014;15(7–8):520–7. Available from: http://dx.doi.org/10.3109/21678421.2014.951944
Chen JH, Wu SC, Chen HJ, Kao CH, Tseng CH, Tsai CH. Risk of developing pressure sore in amyotrophic lateral sclerosis patients – a nationwide cohort study. J Eur Acad Dermatology Venereol. 2018;32(9):1589–96.
Oskarsson B, Moore D, Mozaffar T, Ravits J, Wiedau-Pazos M, Parziale N, et al. Mexiletine for Muscle Cramps in ALS: A Randomized Double Blind Crossover Trial. Mayo Found Med Educ Res. 2018;58(1):42–8.
Caress JB, Ciarlone SL, Sullivan EA, Griffin, Leah P, Cartwright MS. The Natural History of Muscle Cramps in Amyotrophic Lateral Sclerosis. HHS Public Access. 2016;53(4):513–7.
Baldinger R, Katzberg HD, Weber M. Treatment for cramps in amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database of Systematic Reviews. 2012; 4.
Soriani MH, Desnuelle C. Care management in amyotrophic lateral sclerosis. Rev Neurol (Paris) [Internet]. 2017;173(5):288–99. Available from: http://dx.doi.org/10.1016/j.neurol.2017.03.031
Handy CR, Krudy C, Boulis N, Federici T. Pain in amyotrophic lateral sclerosis: A Neglected aspect of disease. Neurol Res Int. 2011;1–8.
Oliver D, Borasio GD, Johnston W. Palliative Care in Amyotrophic Lateral Sclerosis. 4th ed. United Kingdom: Oxford university Press; 2011.
Bromberg MB, Bromberg DB. Navigating Life with Amyotrophic Lateral Sclerosis. United Kingdom: Oxford university Press; 2017.
Andersen PM, Abrahams S, Borasio GD, de Carvalho M, Chio A, Van Damme P, et al. EFNS guidelines on the Clinical Management of Amyotrophic Lateral Sclerosis (MALS) - revised report of an EFNS task force. Eur J Neurol. 2012;19(3):360–75.
Hogan DB. Quinine: Not A Safe Drug for Treating Nocturnal Leg Cramps. Can Med Assoc J. 2015;187(4):248–53.
El‐Tawil S, Al Musa T, Valli H, Lunn MPT, Brassington R, El‐Tawil T, Weber M. Quinine for muscle cramps. Cochrane Database of Systematic Reviews. 2015;4.
Mauskop A. Assessment: Symptomatic treatment for muscle cramps (An Evidence-Based Review): Report of the therapeutics and technology assessment subcommittee of the american academy of neurology. Neurology. 2010;75(15):1397–9.
Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17(9):1113–23.
De Carvalho M, Pinto S, Costa J, Evangelista T, Ohana B, Pinto A. A randomized, placebo-controlled trial of memantine for functional disability in amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2010;11(5):456–60.
Weiss MD, Macklin EA, Simmons Z, Knox AS, Greenblatt DJ, Atassi N, et al. A randomized trial of mexiletine in ALS. Neurology. 2016;86(16):1474–81.
Fudin J, Raouf M. Practical Pain Management [Internet]. A Review of Skeletal Mucle Relaxant Agent Management. 2016 [cited 2020 Jan 9]. Available from: https://www.practicalpainmanagement.com/treatments/pharmacological/non-opioids/review-skeletal-muscle-relaxants-pain-management
Johannes Dorst ACL, Annemarie H. Disease-Modifying and Symptomatic Treatment of Amyotrophic Lateral Sclerosis. Ther Adv Neurol Disord. 2018;11(6):1–16.
Valadi N. Evaluation and Management of Amyotrophic Lateral Sclerosis. Prim Care - Clin Off Pract. 2015;42(2):177–87.
Nair KPS, Marsden J. The management of spasticity in adults. BMJ. 2014;349(4):1–10.
Bethoux F, Boulis N, McClelland S, Willis MA, Hussain M, Machado A, et al. Use of intrathecal baclofen for treatment of severe spasticity in selected patients with motor neuron disease. Neurorehabil Neural Repair. 2013;27(9):828–33.
Rego S, Amorim I, Condeca B, Faria F. Efficacy of a second "drug holiday" in the treatment of intratechal baclofen tolerance - A case study. 2018; 61(5):309-433.
Grimaldi AE, De Giglio L, Haggiag S, Bianco A, Cortese A, Crisafulli SG, et al. The influence of physiotherapy intervention on patients with multiple sclerosis–related spasticity treated with nabiximols (THC:CBD oromucosal spray). PLoS One. 2019;14(7):1–10.
Novotna A, Mares J, Ratcliffe S, Novakova I, Vachova M, Zapletalova O, et al. A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex®), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. Eur J Neurol. 2011;18(9):1122–31.
Riva N, Mora G, Sorarù G, Lunetta C, Ferraro OE, Falzone Y, et al. Safety and efficacy of nabiximols on spasticity symptoms in patients with motor neuron disease (CANALS): a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol. 2019;18(2):155–64.
Ferrari A, Manca M, Tugnoli V, Pini LA. Pharmacological differences and clinical implications of various botulinum toxin preparations: A critical appraisal. Funct Neurol. 2018;33(1):7–18.
Simpson DM, Hallett M, Ashman EJ, Comella CL, Green MW, Gronseth GS, et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016;86(19):1818–26.
Lebeda FJ, Cer RZ, Stephens RM, Mudunuri U. Temporal characteristics of botulinum neurotoxin therapy. Expert Rev Neurother. 2010;10(1):93–103.
Lee M, Silverman S, Hansen H, Patel V, Manchikanti L. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.
Denenberg R, Curtiss CP. CE: Appropriate Use of Opioids in Managing Chronic Pain. Am J Nurs. 2016;116(7):26–38.
Katzung BG, Trevor AJ. Skeletal Muscle Relaxants. In: Kruidering-Hall M, Campbell L, editors. Basic & Clinical Pharmacology. 13th ed. New York: Mc Graw Hill; 2015.
Micromedexsolutions.com [Internet]. Cyclobenzaprine Hydrochloride form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=topHome&isToolPage=true#
Micromedexsolutions.com [Internet]. Metaxalone form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Ashley C, Aileen C, editors. Quinine. In: The Renal Drug Handbook. 4th ed. United Kingdom: Radcliffe Publishing Ltd; 2014.
Wiffen PJ, Derry S, Moore RA, Lunn MPT. Levetiracetam for neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2014;7.
Micromedexsolutions.com [Internet]. Levetiracetam form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/CS/8F8F78/ND_PR/evidencexpert/ND_P/.DoIntegratedSearch?SearchTerm=levetiracetam&UserSearchTerm=levetiracetam&SearchFilter=filterNone&navitem=searchGlobal#
Micromedexsolutions.com [Internet]. Gabapentin form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Micromedexsolutions.com [Internet]. Mexitiletine form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Drugs.com [Internet]. Baclofen Information from Drugs.com; c1996-2020 [Updated: 2 March 2020, Cited: 15 March 2020]. Available from: https://www.drugs.com/mtm/mexiletine.html
Micromedexsolutions.com [Internet]. Baclofen form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/CS/D1C447/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/8837F9/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.DoIntegratedSearch?SearchTerm=baclofen&UserSearchTerm=baclofen&SearchFilter=filterNone&navitem=searchGlobal#
Drugs.com [Internet]. Baclofen Information from Drugs.com; c1996-2020 [Updated: 2 March 2020, Cited: 15 March 2020]. Available from: https://www.drugs.com/cdi/baclofen-intrathecal-injection.html
Mörkl S, Bengesser S, Schöggl H, Bayer D, Kapfhammer H. Tizanidine Withdrawal Symptoms in Stress Cardiomyopathy [in German]. Fortschr Neurol Psychiatr. 2015;83(3):170–3.
Micromedexsolutions.com [Internet]. Tizanidine form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Micromedexsolutions.com [Internet]. Pregabalin form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Micromedexsolutions.com [Internet]. Diazepam form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Micromedexsolutions.com [Internet]. Dantrolene Sodium form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Micromedexsolutions.com [Internet]. Riluzole form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch?navitem=headerLogout#
Micromedexsolutions.com [Internet]. Botulinum form IBM Micromedex; [Updated: March 2020, Cited: 23 March 2020]. Available from: https://www.micromedexsolutions.com/micromedex2/librarian/CS/E80ACA/ND_PR/evidencexpert/ND_P/evidencexpert/evidencexpert.IntermediateToDocumentLink?docId=929376&contentSetId=100&title=AbobotulinumtoxinA&servicesTitle=AbobotulinumtoxinA&topicId=null#
Vázquez-Costa JF, Máñez I, Alabajos A, Guevara Salazar M, Roda C, Sevilla T. Safety and efficacy of botulinum toxin A for the treatment of spasticity in amyotrophic lateral sclerosis: results of a pilot study. J Neurol. 2016;263(10):1954–60.
DOI: https://doi.org/10.15416/ijcp.2020.9.4.327
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