From a Symptom-Based to a Mechanism-Based Pharmacotherapeutic Treatment in Complex Regional Pain Syndrome

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Abstract

Complex regional pain syndrome (CRPS) is a debilitating painful condition of a distal extremity that can develop after tissue damage. CRPS is thought to be a multimechanism syndrome and ideally the most prominent mechanism(s) should be targeted by drugs in an individually tailored manner. This review gives an overview of the action and evidence of current and future pharmacotherapeutic options for CRPS. The available options are grouped in four categories by their therapeutic actions on the CRPS mechanisms, i.e. inflammation, central sensitisation, vasomotor disturbances and motor disturbances. More knowledge about the underlying mechanisms of CRPS helps to specifically target important CRPS mechanisms. In the future, objective biomarkers could potentially aid in selecting appropriate mechanism-based drugs in order to increase the effectiveness of CRPS treatment. Using this approach, current and future pharmacotherapeutic options for CRPS should be studied in multicentre trials to prove their efficacy. The ultimate goal is to shift the symptom-based selection of therapy into a mechanism-based selection of therapy in CRPS.

Original languageEnglish
Pages (from-to)511-531
Number of pages21
JournalDrugs
Volume82
Issue number5
Early online date5 Mar 2022
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Funding Information:
Frank J.P.M. Huygen reports personal fees from Abbott; grants and personal fees from Saluda; and personal fees from Boston Scientific, Grunenthal, and Pfizer outside the submitted work. Thomas J.P. Mangnus, Krishna D. Bharwani, and Maaike Dirckx report no other conflicts of interest that are relevant to the contents of this article.

Publisher Copyright:
© 2022, The Author(s).

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