(026) KEY OUTCOMES OF THE VULVODYNIA SUMMIT: IDENTIFYING THERAPEUTIC OPTIONS FOR FURTHER RESEARCH STUDY IN THE TREATMENT OF PROVOKED VESTIBULODYNIA
Notice bibliographique
Résumé
Abstract Introduction Provoked vestibulodynia is the most common subtype of vulvodynia, chronic vulvar pain which impacts up to 8% of women by the age of 40. As there are no visible signs, it is a diagnosis of exclusion. Neuroproliferation and activated mast cells are nonspecific findings in the setting of provoked vestibulodynia, supporting the theory that inflammation is the critical first step necessary for the generation of pain signals in the vulvar vestibule. The current treatment of provoked vestibulodynia involving neuroproliferation is often complete vestibulectomy; however, less invasive treatments are scientifically plausible yet lack study. Objective Identify therapeutic options for further research study in the treatment of provoked vestibulodynia through expert consensus. Methods The International Society for the Study of Women’s Sexual Health (ISSWSH), the National Vulvodynia Association (NVA), the Gynecologic Cancers Research Foundation and TightLipped, a grassroots non-profit organization to support people with chronic vulvovaginal and pelvic pain, collectively sponsored a consensus conference, which was held April 19-21, 2024 in Washington, D.C. Format consisted of 14 one-hour sessions involving 20 minute presentation and 40 minute discussion by experts and stakeholders in genitopelvic pain. Following the conference, attendees ranked the identified therapeutics in order from 1 to 15 using SurveyMonkey. Results Expert consensus was achieved that vestibulodynia is fundamentally a neuroinflammatory condition. Fifteen therapeutic options were identified and ranked in order of most to least promising for further study to treat the neuroinflammation of vestibulodynia: ketotifen fumarate, Resiniferatoxin, Maresin-1, Luteolin, Alpha-Lipoic Acid, trifluoromethoxyphenyl-3-(1-propionylpiperidin-4-yl) urea (TPPU), NGFR121W-SNAP IR700 trimer exposed to NIR (photoablation), Ketamine, TrkA inhibitors, Palmitoylethanolamide (PEA), Mepyramine, 5% Dextrose injection (neural prolotherapy), Cryoneurolysis, Loperamide, and Salsalate. Ketotifen fumarate, Resiniferatoxin, and Maresin 1 had scores between 10-12 and Luteolin, Alpha-Lipoic Acid and TPPU had a score between 8-10. TPPU was combined with Maresin-1 due to their similar mechanism of action in increasing levels of specialized pro-resolving mediators. Conclusions The top five identified therapeutics for further research in the treatment of provoked vestibulodynia with a neuroinflammatory basis were: Ketotifen fumarate, Resiniferatoxin, specialized pro-resolving mediators and agents that increase their levels (Maresin-1 and TPPU), Luteolin, and Alpha-Lipoic Acid. Although surgery has the most robust clinical data, less invasive therapeutic options that target neuroproliferative and inflammatory causes exist. As evidenced by the findings of the Vulvodynia Summit, there are many therapeutic targets that hold promise in the treatment of provoked vestibulodynia. These treatments have been utilized in adjacent conditions with similar pathophysiology as provoked vestibulodynia. Research funding is necessary to promote study and implementation of these promising therapeutics to provide safe and effective non-surgical treatment options for neuroinflammatory vestibulodynia targeting neuroinflammatory processes. Disclosure Yes, this is sponsored by industry/sponsor: ISSWSH, NVA, TightLipped, Gynecologic Cancers Research Foundation. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: Evvy, Pelva Health, UpToDate (author).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».