Funded Projects

NOFO Title: Notice of Special Interest to Encourage Eligible NIH HEAL Initiative Awardees to Apply for Administrative Supplements to Support Career Enhancement Related to Clinical Research on Pain (Admin Supp – Clinical Trial Not Allowed)
NOFO Number: NOT-NS-21-048
Summary:

Identifying optimal chronic low back pain treatments on a patient-specific basis is an important and unresolved challenge. Tailoring interventions according to patient movement characteristics is one option. This research is characterizing patients based on spinal motion during functional tasks and daily activities and will use artificial intelligence to objectively characterize motions of the spine during both clinical assessments and day-to-day life. During clinical assessments, participants will be asked to perform functional tasks while wearing motion sensors. Data collected from the sensors will be used to identify tasks of interest, such as activities of daily living and aberrant/painful motions. An artificial intelligence approach will then interpret data collected continuously during assessment in patients’ homes over a 7-day testing period. Ultimately, this data could be used to help clinicians tailor treatments that are responsive to a patient’s real-world functional impairments.

NOFO Title: HEAL Initiative: Notice of Special Interest (NOSI) regarding the Availability of Administrative Supplements to Support Strategies to Reduce Stigma in Pain Management and Opioid Use Disorder (OUD) and Treatment
NOFO Number: NOT-OD-20-101
Summary:

While advances in cancer treatment have increased survival rates, these patients often suffer from chronic cancer pain. Prescription opioids are often prescribed during active cancer treatment, but their long-term use for chronic cancer pain is associated with risk for opioid use disorder and risk for stigmatization associated with emotional distress, suboptimal health behaviors and coping strategies, and difficult patient-provider communication. This study aims to conduct qualitative interviews exploring prescription opioid and chronic pain stigma in cancer survivors with moderate-to-severe pain, caregivers, and clinicians who treat patients with chronic cancer pain, including oncologists, primary care providers, pain management specialists, and palliative care physicians. An analysis of potential contributors to stigma in cancer survivors will be completed to support development of multi-level behavioral interventions to reduce stigma and explore long-term health outcomes from such interventions.

NOFO Title: HEAL Initiative: America’s Startups and Small Businesses Build Technologies to Stop the Opioid Crisis (R43/R44 - Clinical Trial Optional)
NOFO Number: RFA-DA-19-019
Summary:

While the mu opioid receptor (MOR) antagonist naloxone has proven invaluable as an opioid overdose antidote, naloxone suffers from a very short duration of action (half-life is approximately 1 hour) and has been found to be less effective against newer, long-acting opioids, including fentanyl (half-life is approximately 7–10 hours). This leads to a highly lethal and increasingly prevalent phenomenon known as “renarcotization,” wherein an overdose patient revived with naloxone can re-enter an overdose state from residual fentanyl in the body. Thus, there is a critical need to develop a long-acting MOR antagonist formulation that can address renarcotization by providing multi-hour protection. The goal of this project is to reformulate naloxone using FDA-approved microencapsulation technology into a long-acting injectable (LAI) that can provide 12–24 hours of sustained antagonist activity in vivo. It will employ a proprietary Computational Drug Delivery™ software, called ADSR™, to perform in silico formulation optimization as well as to predict its in vitro dissolution and in vivo pharmacokinetic behavior.

NOFO Title: Administrative Supplements for Validation of Novel Non-Addictive Pain Targets (Clinical Trials Not Allowed)
NOFO Number: NOT-NS-18-073
Summary:

Severe tissue injury generates central sensitization. Latent sensitization (LS) is a silent form of central sensitization that persists after tissue has healed and overt signs of hyperalgesia have resolved. Pain remission during LS is likely maintained by tonic opioid receptor activity. The opioid receptor inverse agonist, naloxone, can reinstate experimental pain when delivered one week after the resolution of secondary hyperalgesia following first degree thermal injury. Our aims are to test: 1) the hypothesis that burn or surgery triggers LS and long-term opioid analgesia in humans; 2) the hypothesis that mu-opioid receptor (MOR) constitutive activity (MORCA) receptors by opioid peptides maintains endogenous analgesia and restricts LS to a state of pain remission; 3) the extent to which MORs inhibit neural activity in the DH and synaptic strength in presynaptic terminals of primary afferent nociceptors during LS; and 4) whether MORs inhibit spinal NMDA receptor subunits to block pain during LS.

NOFO Title: HEAL Initiative: Optimization of Non-addictive Therapies [Small Molecules and Biologics] to Treat Pain
NOFO Number: RFA-NS-19-020
Summary:

The development of non-addictive pain therapeutics can help counter opioid addiction and benefit patients, including those who suffer from neuropathic pain, in particular diabetic neuropathic pain (DNP). This project’s goal is to develop a safe, efficacious, and non-addictive small-molecule drug that activates Kv7 voltage-gated potassium channels to address overactive neuronal activity in DNP. Researchers will discover Kv7 activators that favor Kv7 isoforms altered in DNP and found in dorsal root ganglia, decrease off-target side effects observed with the use of earlier non-biased Kv7 activators, and optimize the absorption, distribution, metabolism, excretion, and toxicity profiles of these activators. This screening paradigm is intended to establish a clinic-ready, well-tolerated, and widely effective product to treat neuropathic pain.

NOFO Title: HEAL Initiative: Developing Quantitative Imaging and Other Relevant Biomarkers of Myofascial Tissues for Clinical Pain Management
NOFO Number: RFA-AT-22-003
Summary:

Pain in the muscles and surrounding connective tissues (myofascial pain) can affect many regions of the body and is a key component of chronic low back pain. Patients with chronic low back pain have a range of musculoskeletal problems perpetuating their pain. There is a significant clinical need to identify the components of myofascial pain in people with chronic low back pain. Advances in ultrasound technology have allowed researchers to identify several differences in muscle and connective tissues related to myofascial pain. This project will develop and validate an ultrasound-based biomarker signature for myofascial pain in the low back. This research will also refine the biomarker signature using advanced machine learning approaches, toward future testing in in a randomized controlled clinical trial.

NOFO Title: Notice of Special Interest to Encourage Eligible NIH HEAL Initiative Awardees to Apply for Administrative Supplements to Promote Training in Clinical Research on Pain (Admin Supp ? Clinical Trial Not Allowed)
NOFO Number: NOT-NS-20-044
Summary:

Multiple factors, including inflammation contribute to chronic low back pain. Inflammation is mediated by numerous genes. The study aims to determine how variations in the genes encoding key inflammatory mediators impact the response of patients with chronic low back pain to physical therapy treatment. Gene variations that are known to be linked to inflammation and pain will be tested against their possible association on physical therapy treatment outcomes, to inform clinical decisions on optimal care. This study will support training in clinical research on pain within the context of the HEAL BACPAC Mechanistic Research Center. It will provide resources for a research project relevant to the parent grant and the career development of an individual in the field of pain research. The ability to identify a set of genetic variations and classify patients according to treatment response might enable use of DNA testing as a screening tool for targeted treatments for patients with CLBP.

NOFO Title: HEAL Initiative: Early Phase Pain Investigation Clinical Network - Specialized Clinical Centers (U24 Clinical Trial Not Allowed)
NOFO Number: RFA-NS-19-036
Summary:

For many years in the field of pain medicine it has been noted that many promising treatments emerging from animal studies fail to demonstrate efficacy in human trials. There are many reasons for these phenomena, and one of the key steps to improve this situation and establish more effective nonopioid treatments for pain is more rigorous conduct of multisite pain clinical trials from an experienced multidisciplinary team of investigators. The University of Pittsburgh Hub and Spoke Clinical Trials Network will establish an organizational structure to capitalize on institutional expertise at our Spokes to lead specific phase 2 clinical trials through EPPIC-Net.

NOFO Title: HEAL Initiative: Back Pain Consortium (BACPAC) Research Program: Mechanistic Research Centers (U19 Clinical Trial Optional)
NOFO Number: RFA-AR-19-026
Summary:

The University of Pittsburgh Low Back Pain: Biological, Biomechanical, and Behavioral Phenotypes (LB3P) Mechanistic Research Center (MRC) will to perform in-depth phenotyping of patients with chronic low back pain (cLBP), using a multimodal approach to characterize patients and provide insight into the phenotypes associated with experience of cLBP to direct targeted and improved treatments. The LB3P MRC will be formed of three Research Cores, three support cores, and one research project. This approach will leverage and integrate distinctive resources at the University of Pittsburgh laboratories to deliver quantified biomechanical, biological, and behavioral characteristics; functional assessments; and patient-reported outcomes, coupled with advanced data analytics using a novel Network Phenotyping Strategy (NPS). By eliminating isolated and disconnected approaches to treatment and focusing on personalized patient-centric approaches, this approach will yield improved outcomes and patient satisfaction.

NOFO Title: HEAL Initiative: Back Pain Consortium (BACPAC) Research Program: Phase 2 Clinical Trials (UG3/UH3 Clinical Trial Required)
NOFO Number: RFA-AR-19-029
Summary:

The chronic low back pain (cLBP) subgroup with comorbid depression or anxiety disorders, known as high negative affect (NA), needs better non-opioid, comprehensive pain treatment options. Data shows that the combination of antidepressants (AD) and fear avoidance physical therapy is more efficacious at improving pain, function, depression, and anxiety in cLBP patients with high NA than each treatment alone or a control condition. Research also finds that an enhanced fear avoidance rehabilitation protocol (EFAR; fear avoidance-based physical therapy, pain education, and motivational messaging) further improves outcomes. To address the unmet needs of cLBP patients with high NA, this study will test in a randomized trial whether the combination of AD and EFAR is more effective than each treatment alone at relieving pain, improving function, combating depression, and preventing opioid misuse. This multimodal combination approach of pharmacotherapy and behavioral therapy is novel to the field and has the potential to shift current treatment paradigms.

NOFO Title: HEAL Initiative: Sickle Cell Disease Pain Management Trials Utilizing the Pain Management Effectiveness Research Network Cooperative Agreement (UG3/UH3, Clinical Trial Required)
NOFO Number: RFA-AT-23-002
Summary:

Pain is the most common symptom of sickle cell disease (SCD), contributing to poor physical and emotional health outcomes and exacerbating socially determined health disparities at significant societal cost. PRESENCE will be the first study to compare the effectiveness of a cognitive behavioral therapy (CBT) program with and without peer support to usual care as a non-pharmaceutical option for pain management in adolescents and young adults living with SCD. CBT is delivered through an innovative digital app that is accessed on a mobile device with one group receiving self-guided CBT, a second group receiving CBT plus peer support, and a third group receiving usual SCD care. The PRESENCE program is comprised of strong community partnerships that provide the peer support component of the intervention. Measured outcomes will include pain and emotional health.

NOFO Title: HEAL Initiative: Opioid Exposure and Effects on Placenta Function, Brain Development, and Neurodevelopmental Outcomes (R01 Clinical Trial Not Allowed)
NOFO Number: RFA-HD-23-038
Summary:

This project will study the harmful effects of illicit and prescription opioid use during pregnancy and its consequences on the mother, fetus, and placenta. The research will integrate multiple different technologies to study molecular changes in biospecimens taken from research participants. Samples to be collected at birth and characterized include plasma and urine from the mother across the three trimesters of pregnancy, tissue samples of the placenta, and fetal cord blood. This research aims to shed new light on the underlying biology of opioid exposure on the placenta during pregnancy toward development of early interventions during opioid-exposed pregnancies. 

NOFO Title: HEAL Initiative: Research to Foster an Opioid Use Disorder Treatment System Patients Can Count On (RM1 - Clinical Trial Optional)
NOFO Number: RFA-DA-23-046
Summary:

This project will enhance the measurement, quality, and equity of care delivered in 20 community opioid treatment programs in Pennsylvania by co-designing and implementing measurement-based care tools and systems. The research will inform future use of measurement-based care for opioid treatment in partnership with key stakeholders, as well as explore alternative avenues improving health outcomes, including helping patients remain in treatment.