Duke Emergency Medicine Joins EPPIC-Net

Prior to the COVID pandemic, there was a nationwide epidemic with opioid use disorder. Treating pain is a common challenge across almost all disease states, and opioids can be helpful medications. However, their misuse has become a prevalent problem leading to addiction and overdose deaths around the country. Increasing evidence indicates the opioid use disorder worsened during the pandemic due to the multiple stressors involved and disruption to healthcare visits for substance use disorders.

Since 2019, Duke Emergency Medicine has been working with researchers around the country to solve part of the problem: finding new, non-addictive treatments for pain. We are participating in the National Institutes of Health's Helping to End Addiction Long-term (HEAL) Initiative. Specifically, we are participating in a sub-initiative called the Early Phase Pain Investigation Clinical Network (EPPIC-Net).

EPPIC-Net organizes multiple health systems nationwide to conduct phase 2 trials of non-addictive pain interventions. Funded by an EPPIC-Net U24 grant, Alexander T. Limkakeng Jr., MD, MHS, Professor and Vice Chief of Research for the Duke Division of Emergency Medicine, and Francis Keefe, PhD, Professor in the Duke Department of Psychiatry and Behavioral Sciences, are preparing for the first EPPIC-Net trial, which studies a novel agent for knee osteoarthritis.

This trial will require collaboration with Duke investigators from orthopedics and anesthesia under the lead of Emergency Medicine. Patients will be followed for 6 months with a visit every 3 weeks to provide survey and questionnaire data. Investigators will also assess the patient’s ability to walk up and down steps as well as ecological momentary assessment—monitoring the patient’s symptoms in real time using a mobile health app.

The study will acquire a rich data set phenotyping the pain response in many dimensions in individual patients, and the dataset will harmonize with other programs in the HEAL Initiative to create a powerful combined database to study pain. EPPIC-Net is also making plans for additional trials studying new treatments for diabetic neuropathy.