I would like to introduce the National Institutes of Health (NIH) Back Pain Research Consortium (BACPAC), a new patient-centric translational research program that will support studies to dissect the components and mechanisms of chronic low back pain and integrate this information to identify, prioritize and test new therapies targeted to specific mechanisms. NIH BACPAC is part of the NIH HEAL (Helping to End Addiction Long-term) Initiative.
I’m sure it will come as no surprise that back pain is one of the most common forms of chronic pain among adults worldwide. According to National Health Interview Survey data, 20 percent of adults in the United States reported “frequent” back pain and 28 percent of adults experienced low back pain that lasted a whole day or more during the past three months.
Back pain is a major contributor to the use of opioids in the United States. Some non-opioid treatments appear to have mild to moderate effects on chronic back pain and function in some patients, and combination therapies are, in general, more effective than the use of a single therapy. However, at present there is no way to predict what treatments are most likely to be effective in individual patients. Too many patients have persistent low back pain that lasts for months, and some end up on opioids and are at risk for opioid use disorder.
The mechanisms of back pain are likely to be complex. A variety of organs, tissues and cell types interact in an environment heavily influenced by mechanical, physical, biological and biopsychosocial factors that can result in the experience of pain, emotional and social distress, and decreased physical function.
A key and innovative feature of NIH BACPAC is that new information regarding clinical and mechanistic aspects of the disease will be incorporated into diagnostic algorithms. These will be tested and refined in an iterative and continuous fashion. These algorithms will be rapidly applied in the design of new clinical trials testing new interventions and in ongoing combination therapy trials using adaptive design.
This highly collaborative research program will be composed of mechanistic research centers and technology sites that will conduct translational research and phase 2 clinical trials to deliver an integrated model of back pain and patient-based algorithms to facilitate the identification of treatments tailored to the individual patient.
We have released four Funding Opportunity Announcements (FOAs):
- RFA-AR-19-026 - HEAL Initiative: Back Pain Consortium (BACPAC) Research Program: Mechanistic Research Centers (U19 Clinical Trial Optional)
- RFA-AR-19-027 - HEAL Initiative: Back Pain Consortium (BACPAC) Research Program Data Integration, Algorithm Development and Operations Management Center (U24 Clinical Trial Not Allowed)
- RFA-AR-19-028 - HEAL Initiative: Back Pain Consortium (BACPAC) Research Program Technology Research Sites (UH2/UH3 Clinical Trial Optional)
- RFA-AR-19-029 - HEAL Initiative: Back Pain Consortium (BACPAC) Research Program: Phase 2 Clinical Trials (UG3/UH3 Clinical Trial Required)
I invite you to learn more about NIH BACPAC and to stay updated on this exciting initiative by visiting our NIH BACPAC Research Program website and by following NIAMS on Twitter and Facebook.
To view the full list of related funding opportunities, events, news and announcements, visit the NIH HEAL InitiativeSM website.
Stephen I. Katz, M.D., Ph.D.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institutes of Health