Trial reportPain medicine (Malden, Mass.)2025
Enhanced pain relief with guanfacine as an adjuvant for trigeminal nerve blocks: insights from a PheWAS-guided randomized controlled study.
Trial report in Pain medicine (Malden, Mass.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03865940 (A Randomized, Double-Blind, 2-Way Crossover Trial to Assess the Efficacy of Guanfacine and Lidocaine Combination Versus Lidocaine Alone in Trigeminal Nerve Block for Pain Management in Painful Trigeminal Neuropathy Patients), which is not on this map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized, Double-Blind, 2-Way Crossover Trial to Assess the Efficacy of Guanfacine and Lidocaine Combination Versus Lidocaine Alone in Trigeminal Nerve Block for Pain Management in Painful Trigeminal Neuropathy Patients
Who cites it
1 citing paper in PubMed.
- Guanfacine as a potential preventive therapy for chronic migraine: a mechanistic hypothesis.Frontiers in neurology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundTrigeminal neuralgia and painful trigeminal neuropathy are severely painful conditions which are often difficult to treat with medications. A Phenome-Wide Association Study (PheWAS) analysis identified an association between single-nucleotide variants in the alpha-2 adrenergic receptor (ADRA2) subtype B, a G protein-coupled receptor expressed on peripheral and central presynaptic terminals, and an increased risk for trigeminal nerve disorders. We hypothesized that adding the ADRA2 agonist guanfacine to routine care trigeminal nerve injections would provide enhanced pain relief in trigeminal neuralgia than routine care alone.
methodsPheWAS analysis identified the drug target/indication pair. The trial was a single-center, prospective, randomized, controlled, double-blinded, 2-way crossover trial for patients with pain attributed to the trigeminal nerve. Injections of lidocaine alone or lidocaine + 250 µg guanfacine were delivered to the V2 and V3 branches of the trigeminal nerve by experienced clinicians. Patients reported pain using a Numeric Rating Scale (NRS) and quality of life measures (using the PROMIS Global Physical Health, Mental Health, and Pain Interference surveys).
resultsNRS pain scores over the first 8 h post-injection were significantly lower in the interventional group (guanfacine + lidocaine) compared to active control (P < .001), but not from day 1 through day 14. There was no significant difference between treatment groups in time to recovery of baseline pain intensity (primary outcome), PROMIS outcomes, or adverse events (AEs). No serious AEs were reported.
conclusionsThe addition of 250 µg guanfacine to lidocaine for a nerve block procedure enhanced analgesia compared to lidocaine alone within the first 8 h post-injection. CLINICAL TRIAL NUMBER: NCT03865940, https://clinicaltrials.gov/study/NCT03865940.
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