What’s New in Combination Pharmacotherapy for Neuropathic Pain? From Bench to Bedside

Laura Stone will illustrate the therapeutic potential of combination pharmacotherapy by highlighting – with recent examples – additive and synergistic analgesic interactions using preclinical investigative techniques. The rationale for picking certain targets for combinations will be presented as will issues of adverse drug interactions. Ian Gilron will provide a recently updated evidence-based review of combination pharmacotherapy for neuropathic pain in order to highlight critical issues surrounding optimal combinations and necessary improvements for future combination trials. Key issues relating to combination therapy will be discussed including: 1) safety 2) simultaneous versus sequential “add-on” therapy; and 3) optimal use of fixed dose combinations. Flemming Bach will discuss combination pharmacotherapy in the context of real-world neuropathic pain. This will include a review of safe and effective evidence-based pain management practices by discussing known adverse drug interactions. The challenges and limitations of combination therapy with currently available drugs will also be presented. In particular consideration of the narrow therapeutic window due to cognitive side effects represent an obstacle and calls for consideration of alternative combination approaches.