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Oral Methotrexate Significantly Improves Function in People with Primary Knee OA with Inflammation After Only 3 Months

A new study presented at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that after three months of treatment with oral methotrexate, adults with primary knee osteoarthritis (OA) with inflammation had significant improvements in physical function and inflammation, a sign that this inexpensive, generic pill may be an important intervention for knee OA (ABSTRACT #1648). Read more.

Congratulations to Inaugural AAPM Early Investigator Research Grant Recipient, Ben Alter, MD PhD

June 17, 2020, CHICAGO –   The AAPM Early Investigator Research Grant was created in partnership with US WorldMeds to support preliminary or pilot research projects relevant to a comprehensive, multidisciplinary, patient-centered approach to pain management. AAPM members who are early stage investigators were invited to submit proposals for the opportunity to receive a $15,000 one-year grant.

AAPM is pleased to announce Ben Alter, MD PhD as the recipient of AAPM’s inaugural Early Investigator Research Grant. The grant will support Dr. Alter’s research entitled Brain biomarker of endogenous analgesia in patients with chronic knee pain. Dr. Alter is an Assistant Professor and the Director for Translational Pain Research in the Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh. After studying medicine and neuroscience at Washington University, he completed training in anesthesiology at University of California, San Francisco and pain medicine at the University of Pittsburgh. 

Dr. Alter’s research explores how the brain modulates pain and how endogenous pain dampening systems can be systematically leveraged for novel pain therapies. The objective of his AAPM Research Grant-funded study is to assess whether functional near-infrared spectroscopy (fNIRS) can be used to detect changes in cortical activity during endogenous analgesia in patients with chronic knee pain from osteoarthritis. Using this alternative brain imaging technique will enable hemodynamic changes in the cerebral cortex to be measured by recording low-intensity infrared light absorption by hemoglobin over time. fNIRS is portable, scalable, can be collected in the ambulatory setting, and does not require supine positioning.

According to Dr. Alter, recent evidence suggests that endogenous analgesia is diminished in chronic pain states. Interestingly, the brain circuitry implicated in endogenous analgesia also appears to change in chronic pain states, as measured by functional magnetic resonance imaging (fMRI) techniques. As such, both psychophysical tests thought to reflect endogenous analgesia and fMRI measures are potential chronic pain biomarkers. However, the relative importance of these changes to the pathophysiology of chronic pain remains unknown, partly due to a lack of prospective studies in patients in relation to their course of chronic pain. Major barriers to these studies are the cost and patient tolerability of repeated fMRI sessions.

Research shows that mechanistically relevant biomarkers may allow for personalization of chronic pain management. It is hoped that Dr. Alter’s research will lead to the discovery of the brain biomarker of endogenous analgesia in patients with chronic knee pain.

“I am honored to be selected for this grant. This pilot grant will jump start promising research that I hope will improve pain care for patients dealing with chronic pain. It was truly made possible with the mentorship and support of my friends and colleagues at Pitt and beyond,” commented Dr. Alter. AAPM wishes him and his team the best as they utilize this early investigator grant.

About AAPM

The American Academy of Pain Medicine is the premier medical association for pain physicians and their treatment teams with some 2,000 members. Now in its 37th year of service, the Academy’s mission is to advance and promote the full spectrum of multidisciplinary pain care, education, advocacy, and research to improve function and quality of life for people in pain. Information is available on the Academy’s website at painmed.org

Phenol Neurolysis of Genicular Nerves for Chronic Knee Pain

Study Description: Brief Summary: Chronic knee pain from osteoarthritis (OA) is commonly treated with total knee arthroplasty (TKA) when conservative therapies fail to provide pain relief. More than 600,000 TKAs are performed in the U.S. annually, a number that continues to increase. A logistic-regression model suggests that the incidence rate of TKA will increase by 143% in the United States by 2050 compared to 2012. Although TKA is successful in reducing knee pain and joint stiffness in most cases, it can be associated with a 7-35% incidence of persistent refractory post-surgical knee pain.

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