Scientometric assessment of drugs for chronic pain, 1979-2013: rapid growth of publications, paucity of successful drugs

Igor Kissin, Igor Kissin

Abstract

The aim of this study was to find signs of progress in the pharmacotherapy of chronic pain over the past 35 years using scientometric analysis. The following scientometric indices were used: 1) popularity index, representing the share of articles on a specific drug(s) relative to all articles in the field of chronic pain; 2) index of change, representing the degree of growth in publications on a topic from one period to the next; 3) index of expectations, representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000) biomedical journals covered by PubMed; and 4) index of ultimate success, representing a publication outcome when a new drug takes the place of a common drug previously used for the same purpose. Publications on 55 drugs used in the treatment of chronic pain were assessed during seven 5-year periods, from 1979 to 2013. The rate of rise in the number of publications on chronic pain was exponential, with an increase of nearly ninefold from 2,346 articles over the 5-year period 1979-1983 to 21,095 articles in 2009-2013. However, despite this huge increase in publications, our scientometric analysis did not reveal signs of really successful drugs in this field. For the 2009-2013 period, the popularity index had a meaningful magnitude (from 0.5-2.8) for only 13 of 55 drugs. Five of them were opioids, including morphine, which had the highest index value of all drugs (2.8). None of the drugs had a high index of expectations in 2009-2013. The index of ultimate success was positive only with triptans in the relatively limited area of acute treatment of migraine. As a result, despite rapid growth in the number of publications, our scientometric analysis did not reveal signs of substantial progress in the field of pharmacotherapy for chronic pain.

Keywords: NSAIDs; anticonvulsants; antidepressants; headache; lower-back pain; migraine; neuropathic pain; opioids; osteoarthritis; postherpetic neuralgia; triptans.

Figures

Figure 1
Figure 1
Time course of popularity index for major classes of drugs used for the treatment of chronic pain. The popularity index represents the share (percentage) of articles on a specific class of drugs relative to all articles in the field of chronic pain during a 5-year period. The inset shows the 5-year rate of growth in the actual number of articles. Abbreviation: NSAIDs, nonsteroidal anti-inflammatory drugs.
Figure 2
Figure 2
Time course of drug supplantation in three different fields of pharmacotherapy: migraine (A), gastroesophageal reflux (GERD) (B), and mycoses (C). The popularity index reflects the very prolonged process of an old drug(s) being supplanted by a new one.
Figure 3
Figure 3
Five-year growth rate of the number of articles on migraine, 1979–2013: migraine versus migraine AND serotonin. The index of change represents the degree of growth (percentage) in publications on a topic during a 5-year period compared to the previous 5-year period.

References

    1. Pizzo PA, Clark NM. Alleviating suffering 101 – pain relief in the United States. N Engl J Med. 2012;366:197–199.
    1. Patel KV, Guralnik JM, Dansie EJ, Turk DC. Prevalence and impact of pain among older adults in the United States: findings from 2011 National Health and Aging Trends Study. Pain. 2013;154:2649–2657.
    1. Kissin I. Can a bibliometric indicator predict the success of a drug? Scientometrics. 2011;86:785–795.
    1. Kissin I, Bradley EL., Jr Top Journals Selectivity Index: is it acceptable for drugs beyond the field of analgesia? Scientometrics. 2011;88:589–597.
    1. Kissin I, Bradley EL., Jr Top Journal Selectivity Index and ‘me-too’ drugs. Scientometrics. 2012;91:131–142.
    1. Kissin I. An early indicator of drug success: Top Journal Selectivity Index. Drug Des Devel Ther. 2013;7:93–98.
    1. Correll DJ, Vlassakov KV, Kissin I. No evidence of real progress in treatment of acute pain, 1993–2012: scientometric analysis. J Pain Res. 2014;7:199–210.
    1. Kissin I. The development of new analgesics over the past 50 years: a lack of real breakthrough drugs. Anesth Analg. 2010;110:780–789.
    1. Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain. 1979;6:249. [No authors listed]
    1. Merskey H, Bogduk N. Classification of Chronic Pain: Description of Chronic Pain Syndromes and Definitions of Pain Terms. 2nd ed. Seattle: IASP; 1994.
    1. Fishman SM, Ballantyne JC, Rathmell JP, editors. Bonica’s Management of Pain. 4th ed. Philadelphia: Wolters Kluwer/Lippincot Williams & Wilkins; 2010.
    1. McMahon SB, Koltzenburg M, editors. Wall and Melzack’s Textbook of Pain. 5th ed. London: Churchill Livingstone; 2006.
    1. Brunton LL, editor. Goodman and Gilman’s Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw Hill Medical; 2011.
    1. Jensen TS, Wilson PR, Rice AS, editors. Chronic Pain: Clinical Pain Management. 2nd ed. London: Hodder Arnold; 2003.
    1. American Pharmacists Association . Drug Information Handbook. 22nd ed. Hudson, OH: Lexicomp; 2013.
    1. Kalso E, Edwards JE, Moore RA, McQuay HJ. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain. 2004;112:372–380.
    1. Martell BA, O’Connor PG, Kerns RD, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Ann Intern Med. 2007;146:116–127.
    1. Noble M, Tregear SJ, Treadwell JR, Schoelles K. Long-term opioid therapy for chronic noncancer pain: a systematic review and meta-analysis of efficacy and safety. J Pain Symptom Manage. 2008;35:214–228.
    1. Nüesch E, Rutjes AW, Husni E, Welch V, Jüni P. Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev. 2009:CD003115.
    1. Finnerup NB, Otto M, McQuay HJ, Jensen TS, Sindrup SH. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005;118:289–305.
    1. Kissin I. Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety? J Pain Res. 2013;6:513–529.
    1. Salinas GD, Robinson CO, Abdolrasulnia M. Primary care physician attitudes and perceptions of the impact of FDA-proposed REMS policy on prescription of extended-release and long-acting opioids. J Pain Res. 2012;5:363–369.
    1. Loeser JD. Five crises in pain management. Pain Clin Updates. 2012;20:1–4.
    1. Humphrey PP, Feniuk W, Perren MJ, Beresford IJ, Skingle M, Whalley ET. Serotonin and migraine. Ann N Y Acad Sci. 1990;600:587–598.
    1. Cooper TG, Noonan E, von Eckardstein S, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16:231–245.

Source: PubMed

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