Chemotherapy-induced peripheral neuropathy (CIPN) is a side effect oncology professionals see all too often among cancer patients who receive neurotoxic chemotherapy drugs. While practitioners are doing their best to treat this painful side effect, one FDA-approved drug is making its way into the spotlight.
Up to 40 percent of cancer patients who receive neurotoxic chemotherapy drugs such as taxanes, platinum agents, and vinca alkaloids will experience painful peripheral neuropathy. Unfortunately, this side effect can exist short term or persist for years into survivorship. This in turn can create a quality-of-life issue for many, and since CIPN is difficult to treat, this makes the issue even more problematic.
According to a recent study, the anti-depressant drug duloxetine, also known as Cymbalta, is showing significant results for those cancer patients experiencing CIPN.
Historically, duloxetine has been offered as a treatment option for those patients with diabetic neuropathy and also for patients diagnosed with depression, anxiety, and fibromyalgia. But now, study results show that CIPN may be another indication to add to the list -- evidence has shown that serotonin and norepinephrine dual reuptake inhibitors are effective in treating neuropathy-related pain.
University of Michigan School of Nursing professor Ellen M. Lavoie Smith, Ph.D. and her team of researchers conducted a Phase 3 trial to examine whether or not duloxetine would reduce the symptoms associated with CIPN.
Between April 2008 and March 2011, 231 patients treated at various medical centers were randomized to receive either duloxetine followed by placebo or vice versa. In order for patients to be eligible, they had to have a pain score of at least a four on a one to 10 pain scale and the recipient of either a taxane or an oxaliplatin-based drug.
Once the study follow-up was completed in July 2012, researchers noted that patients who received duloxetine first reported a larger decrease in pain compared to the placebo-first group -- a 59 percent decrease compared to a 38 percent difference to be exact. Also, patients who received the platinum-based chemotherapy drugs seemed to experience more benefit from duloxetine in comparison to those who received taxane therapy.
The overall result shows that patients who received five weeks of duloxetine had a statistically and clinically significant improvement in pain compared to those who received placebo. In addition, duloxetine may have a greater benefit for those cancer patients receiving oxaliplatin-based therapy rather than a taxane.
Has your clinic provided duloxetine to patients off-label for those experiencing CIPN? If so, have you noticed any improvements in regards to pain and numbness?
- Newswise: Medication Duloxetine Helps Reduce Pain From Chemotherapy