{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:14:42Z","timestamp":1791357282985,"version":"4.3.1"},"reference-count":46,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T00:00:00Z","timestamp":1557964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Pain is one of the most common symptoms that weighs on life\u2019s quality and health expenditure. In a reality where increasingly personalized therapies are needed, the early use of genetic tests that highlights the individual response to analgesic drugs could be a valuable help in clinical practice. The aim of this preliminary study is to observe if the therapy set to 5 patients suffering of chronic or acute pain is concordant to the Pharmacogenetic test (PGT) results. Materials and Methods: This preliminary study compares the genetic results of pharmacological effectiveness and tolerability analyzed by the genetic test Neurofarmagen Analgesia\u00ae, with the results obtained in clinical practice of 5 patients suffering from acute and chronic pain. Results: Regarding the genetic results of the 5 samples analyzed, 2 reports were found to be completely comparable with the evidences of the clinical practice, while in 3 reports the profile of tolerability and effectiveness were partially discordant. Conclusion: In light of the data not completely overlapping with results observed in clinical practice, further studies would be appropriate in order to acquire more information on the use of Neurofarmagen in routine clinical settings.<\/jats:p>","DOI":"10.3390\/medicina55050147","type":"journal-article","created":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T11:21:22Z","timestamp":1558005682000},"page":"147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pharmacogenetic Testing in Acute and Chronic Pain: A Preliminary Study"],"prefix":"10.3390","volume":"55","author":[{"given":"Lorenzo","family":"Panella","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, ASST Gaetano Pini\u2014CTO, Via Isocrate 19, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Volont\u00e8","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, ASST Gaetano Pini\u2014CTO, Via Isocrate 19, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Poloni","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Caserta","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, ASST Gaetano Pini\u2014CTO, Via Isocrate 19, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Ielmini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2163-8025","authenticated-orcid":false,"given":"Ivano","family":"Caselli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9248-1603","authenticated-orcid":false,"given":"Giulia","family":"Lucca","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-9988","authenticated-orcid":false,"given":"Camilla","family":"Callegari","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1053\/ajem.2002.32643","article-title":"The high prevalence of pain in emergency medical care","volume":"20","author":"Cordell","year":"2002","journal-title":"Am. J. Emerg. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1177\/204946370900300102","article-title":"The Cost and Burden of Chronic Pain","volume":"3","author":"Phillips","year":"2009","journal-title":"Rev. Pain"},{"key":"ref_3","first-page":"103","article-title":"A single case report of recurrent surgery for chronic back pain and its implications concerning a diagnosis of M\u00fcnchausen syndrome","volume":"21","author":"Callegari","year":"2006","journal-title":"Funct. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/papr.12305","article-title":"Inventory of Personal Factors Influencing Conditioned Pain Modulation in Healthy People: A Systematic Literature Review","volume":"16","author":"Hermans","year":"2016","journal-title":"Pain Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1097\/j.pain.0000000000000775","article-title":"Individual Differences in Pain: Understanding the Mosaic that Makes Pain Personal","volume":"158","author":"Fillingim","year":"2017","journal-title":"Pain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1037\/a0013628","article-title":"Opioids and the treatment of chronic pain: Controversies, current status, and future directions","volume":"16","author":"Rosenblum","year":"2008","journal-title":"Exp. Clin. Psychopharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/00325481.2016.1147925","article-title":"Psychopharmacology of chronic pain: A focus on antidepressants and atypical antipsychotics","volume":"128","author":"Khouzam","year":"2016","journal-title":"Postgrad. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/YIC.0000000000000127","article-title":"Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders: A systematized review","volume":"31","author":"Albert","year":"2016","journal-title":"Int. Clin. Psychopharmacol."},{"key":"ref_9","first-page":"521","article-title":"Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists","volume":"43","author":"Cohen","year":"2018","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1097\/AJP.0000000000000443","article-title":"Evaluating the Association Between Acute and Chronic Pain After Surgery: Impact of Pain Measurement Methods","volume":"33","author":"Gilron","year":"2017","journal-title":"Clin. J. Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"66","DOI":"10.5603\/AIT.2017.0010","article-title":"Methods of pain assessment in adult intensive care unit patients\u2014Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale)","volume":"49","author":"Kotfis","year":"2017","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/j.1601-0825.2008.01458.x","article-title":"Genetic contributions to pain: A review of findings in humans","volume":"14","author":"Fillingim","year":"2008","journal-title":"Oral Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1177\/2049463713506408","article-title":"Human pain and genetics: Some basics","volume":"7","author":"James","year":"2013","journal-title":"Br. J. Pain"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/jmedgenet-2011-100386","article-title":"Genetic basis of pain variability: Recent advances","volume":"49","author":"Young","year":"2012","journal-title":"J. Med. Genet."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1177\/2049463713507439","article-title":"Pharmacogenetics of analgesic drugs","volume":"7","author":"Cregg","year":"2013","journal-title":"Br. J. Pain"},{"key":"ref_16","first-page":"217","article-title":"CYP2D6 phenotypes are associated with adverse outcomes related to opioid medications","volume":"10","author":"Olson","year":"2017","journal-title":"Pharmgenom. Pers. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/j.1476-5381.2010.00709.x","article-title":"Genetic polymorphisms and drug interactions modulating CYP2D6 and CYP3A activities have a major effect on oxycodone analgesic efficacy and safety","volume":"160","author":"Samer","year":"2010","journal-title":"Br. J. Pharmacol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/FPC.0000000000000186","article-title":"CYP2C9 variants as a risk modifier of NSAID-related gastrointestinal bleeding: A case-control study","volume":"26","author":"Figueiras","year":"2016","journal-title":"Pharmacogenet. Genom."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/j.1369-1600.2012.00442.x","article-title":"Association of \u00b5-opioid receptor (OPRM1) gene polymorphism with response to naltrexone in alcohol dependence: A systematic review and meta-analysis","volume":"17","author":"Chamorro","year":"2012","journal-title":"Addict. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/bcpt.12757","article-title":"Genetic Influences of OPRM1, OPRD1 and COMT on Morphine Analgesia in a Multi-Modal, Multi-Tissue Human Experimental Pain Model","volume":"121","author":"Nielsen","year":"2017","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S0304-3959(00)00486-3","article-title":"Response variability to analgesics: A role for non-specific activation of endogenous opioids","volume":"90","author":"Amanzio","year":"2001","journal-title":"Pain"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0304-3959(87)91074-8","article-title":"The short-form McGill Pain Questionnaire","volume":"30","author":"Melzack","year":"1987","journal-title":"Pain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S240","DOI":"10.1002\/acr.20543","article-title":"Measuresof adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)","volume":"63","author":"Hawker","year":"2011","journal-title":"Arthritis Care Res. (Hoboken)"},{"key":"ref_24","first-page":"239","article-title":"Physical and psychic elements in chronic pain","volume":"98","author":"Callegari","year":"2007","journal-title":"Recenti Prog. Med."},{"key":"ref_25","first-page":"167","article-title":"Chronic Pain: Where the Body Meets the Brain","volume":"126","author":"Crofford","year":"2015","journal-title":"Trans. Am. Clin. Climatol. Assoc."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Arellano, A.L., Martin-Subero, M., Monerris, M., Llerena, A., Farr\u00e9, M., and Montan\u00e9, E. (2017). Multiple adverse drug reactions and genetic polymorphism testing. A case report with negative result. Medicine (Baltimore), 96.","DOI":"10.1097\/MD.0000000000008505"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"425","DOI":"10.36076\/ppj.2014\/17\/425","article-title":"A review of the role of genetic testing in pain medicine","volume":"17","author":"Trescot","year":"2014","journal-title":"Pain Physician"},{"key":"ref_28","first-page":"10","article-title":"The role of pharmacogenetic testing in the treatment of bipolar disorder: Preliminary results","volume":"59","author":"Ielmini","year":"2018","journal-title":"Minerva Psichiatrica"},{"key":"ref_29","first-page":"35","article-title":"The utility of pharmacogenetic testing to support the treatment of bipolar disorder","volume":"11","author":"Ielmini","year":"2018","journal-title":"Pharmgenom. Pers. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s40122-017-0069-2","article-title":"Genetic Testing for Opioid Pain Management: A Primer","volume":"6","author":"Agarwal","year":"2017","journal-title":"Pain Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/j.pain.0000000000000440","article-title":"Complexity, comorbidity, and health care costs associated with chronic widespread pain in primary care","volume":"157","author":"Kostov","year":"2016","journal-title":"Pain"},{"key":"ref_32","first-page":"87","article-title":"Antiepileptic drug use in a nursing home setting: A retrospective study in older adults","volume":"31","author":"Callegari","year":"2016","journal-title":"Funct. Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/0304-3959(93)90120-E","article-title":"Ethnocultural influences on variation in chronic pain perception","volume":"52","author":"Bates","year":"1993","journal-title":"Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1093\/hmg\/ddi013","article-title":"Genetic basis for individual variations in pain perception and the development of a chronic pain condition","volume":"14","author":"Diatchenko","year":"2005","journal-title":"Hum. Mol. Genet."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.pain.2008.08.011","article-title":"Pain, frailty and comorbidity on older men: The CHAMP study","volume":"140","author":"Blyth","year":"2008","journal-title":"Pain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/1745-0179-2-31","article-title":"Pain and psychiatry: A critical analysis and pharmacological review","volume":"6","author":"Marazziti","year":"2006","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_37","first-page":"386","article-title":"Recovery style, symptoms and psychosocial functioning in psychotic patients: A preliminary study","volume":"48","author":"Poloni","year":"2013","journal-title":"Riv. Psichiatr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"387","DOI":"10.2147\/PRBM.S153377","article-title":"Epidemiology and evolution of the diagnostic classification of factitious disorders in DSM-5","volume":"10","author":"Caselli","year":"2017","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"9724371","DOI":"10.1155\/2017\/9724371","article-title":"The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain","volume":"2017","author":"Sheng","year":"2017","journal-title":"Neural Plast."},{"key":"ref_40","first-page":"176","article-title":"Metabolic side effects of second generation antipsychotics in drug-na\u00efve patients: A preliminary study","volume":"44","author":"Diurni","year":"2009","journal-title":"Riv. Psichiatr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1006\/mgme.2001.3204","article-title":"Genetic polymorphisms in drug-metabolizing enzymes and drug targets","volume":"73","author":"Hiratsuka","year":"2001","journal-title":"Mol. Genet. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/joim.12317","article-title":"Polymorphism in CYP2D6 and CYP2C19, members of the cytochrome P450 mixed-functionoxidase system, in the metabolism of psychotropic drugs","volume":"277","author":"Stingl","year":"2015","journal-title":"J. Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1517\/17425255.2011.565051","article-title":"Pain management in the 21st century: Utilization of pharmacogenomics and therapeutic drug monitoring","volume":"7","author":"Jannetto","year":"2011","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.psychres.2011.03.011","article-title":"Are CYP1A2*1F and *1C associated with clozapine tolerability?: A preliminary investigation","volume":"189","author":"Bolla","year":"2011","journal-title":"Psychiatry Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.psychres.2012.07.002","article-title":"Association between CYP1A2 polymorphisms and clozapine-induced adverse reactions in patients with schizophrenia","volume":"200","author":"Ferrari","year":"2012","journal-title":"Psychiatry Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/gim.2016.33","article-title":"Rare genetic variants in cellular transporters, metabolic enzymes, and nuclear receptors can be important determinants of interindividua differences in drug response","volume":"19","author":"Kozyra","year":"2017","journal-title":"Genet. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/5\/147\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:52:36Z","timestamp":1760187156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/5\/147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,16]]},"references-count":46,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5]]}},"alternative-id":["medicina55050147"],"URL":"https:\/\/doi.org\/10.3390\/medicina55050147","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,16]]}}}