Center for Technology Commercialization

PERSONALIZING PAIN MANAGEMENT WITH OPIOIDS

CHMC Ref. id. 2010-0914 and 2012-0506

Overview:

In the US alone, each year >5 million children (and >25 million adults) undergo painful surgery. Inadequate pain relief and serious side effects from perioperative opioids occur frequently in up to 50% of children. Several deaths and serious adverse effects such as respiratory depression have been caused by opioids in children. Most of the opioid related deaths in children could have been avoided with better risk prediction and tailored interventions. Safe and effective analgesia is an important unmet critical medical need in children due to an almost complete lack of understanding of how genetic variability affects surgical pain and adverse responses to opioids. Unexplained large inter-patient variations along with narrow therapeutic indices of opioids significantly compromise patients’ safety, satisfactory pain relief and increase economic burden with prolonged PACU and hospital stays.

Currently there are no robust clinical standards or models or research to guide predictive and personalized opioid pain management in children and adults. By identifying currently unknown high risk factors of opioid related adverse effects and poor pain, and facilitating personalized interventions with clinical decision algorithms we can expect to improve perioperative clinical (better analgesia with minimal adverse effects) and economic outcomes.

By confirming many of the previous genotype-phenotype associations reported in literature, we have found several strong novel associations with clinically and economically important outcome measures, gene-gene interactions and gene-nongenetic factor interactions which are critical in connecting clinically important dots in predicting and personalizing care and reducing adverse clinical and economical outcomes in children and adults.

Applications:

· Rapid point-of-care genotyping for personalized pain management

· Opioid pain research

Advantages:

· Personalize dosing of opioids for better safety

· More effective acute pain management

· Proactive risk identification and Prevention of opioid-related adverse events

· Potential for savings to healthcare system such as shorter hospital stays and decreased medical interventions

Patent Information:

· Multiple Patent Applications Pending

Cincinnati Children's Lead Inventor:

Dr. Senthil Sadhasivam, M.D., MPH