Clinical Scorecard: Staying the Course: Sitting Down With Mike Cooke
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Staying the Course
Key Mechanisms
Mechanisms or clinical associations described in the source article.
Target Population
Potential use in localized post-operative pain, including procedures such as knee surgery; AMT-143 is investigational.
Care Setting
Investigational post-operative pain management; the article says a Phase II study is being prepared.
Key Highlights
Clinicians consulted by AmacaThera in 2014 identified non-opioid post-operative pain management as an unmet need.
The hydrogel is designed to be injected and remain in place after entering the body.
AmacaThera reports completing Phase I studies of the hydrogel alone and combined with an anesthetic.
The company is preparing a Phase II study of its investigational program AMT-143 with Pacira.
The interviewee notes that opioids may still be needed for some major, highly painful surgeries.
Guideline-Based Recommendations
Diagnosis
Management
The interviewee says local anesthetics may manage pain in some smaller or relatively minor surgeries and opioid use should be avoided where possible in those cases.
The article describes AMT-143 as investigational and does not recommend its clinical use.
Monitoring & Follow-up
Risks
The interviewee says opioid use comes with issues but does not specify them.
The interviewee says solution-based local anesthetic effects can wear off relatively quickly.
The interviewee says some major surgeries, such as thoracotomy, can cause pain requiring opioids.
Patient & Prescribing Data
Potential application discussed for localized post-operative pain, including knee surgery.
The article describes an investigational hydrogel intended to keep a drug localized for sustained delivery. It provides no dosing or prescribing instructions.
Clinical Best Practices
The interviewee describes consulting surgeons and anesthesiologists to identify unmet needs in post-operative pain management.
A 20-year national survey reveals substantial gains in infection surveillance but inconsistent use of strategies to limit unnecessary urinary catheterization.
Harold Burstein, MD, PhD, and Laura S. Dominici, MD, FACS, discuss highlights from the SENOMAC trial which sheds light on whether some patients with early breast cancer and limited lymph node involvement can safely avoid additional axillary surgery.
