VA Research Wrap Up: New findings on drug safety, chronic pain and infection

VA’s Office of Research and Development recently published three News Briefs highlighting a new drug safety tool, therapy for chronic pain, and the connection between metabolic syndrome and C. diff infection.

MVP leads to new tool predicting drug safety risks

VA Million Veteran Program researchers led a team that developed a genomic atlas to predict adverse drug reactions.

The research team then released an interactive web interface of the atlas that allows for filtering by gene, drug phase, and how a drug works on the body. The team analyzed almost 17,000 genes, demonstrating the capacity to predict hundreds of known adverse drug reactions for approved medications and suggest other potential adverse interactions.

Genetic variants linked to immune-related pathways were particularly prominent in drug reactions, suggesting attention should be given to medications that work on these pathways. The new gene atlas could be a powerful new tool to predict and improve drug safety.

View the full study from “PLoS Genetics.”

Brief behavioral therapy improves chronic pain interference

Researchers from the VA Center for Integrated Healthcare demonstrated that brief cognitive behavioral therapy can rapidly improve chronic pain interference.

The study divided 184 Veterans with moderate to severe chronic pain into two groups: those receiving the usual pain care and those receiving six, 30-minute sessions of psychoeducation, behavioral and cognitive skills, and relapse prevention, along with the usual pain care, delivered over 12 weeks.

Veterans receiving the brief cognitive therapy had greater improvements in how much pain interfered with life during treatment and still sustained those improvements three months later. The behavioral treatment was also associated with improved physical quality of life and sleep quality.

The results suggest even brief behavioral therapy can lead to improvements in pain outcomes.

View the full study from the journal “Pain.”

Metabolic syndrome increases risk of C. diff infection

Metabolic syndrome is a condition combining obesity and factors such as insulin resistance, high blood pressure and low, good cholesterol, which increases the risk of heart disease, stroke and type 2 diabetes.

A Tucson VA study found it also nearly doubles the risk of Clostridioides difficile (C. diff) infection, a contagious bacterium that causes diarrhea and colon inflammation.

The analysis of almost four million patients from 30 countries revealed metabolic syndrome increased the odds of C. diff infection by 94%, while obesity alone increases the risk by 14%, and diabetes alone increases the risk by 11%.

Metabolic syndrome can alter the gut microbiota and increase chronic inflammation, altering the immune system, according to the researchers. The results suggest a need to consider patients’ metabolic health to prevent and treat C. diff infection.

View the full study from “Open Forum Infectious Diseases.”

For more Office of Research and Development updates, visit ORD online or go to https://www.research.va.gov/news_briefs/.