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Medication duloxetine helps reduce pain from chemotherapy
Date:4/2/2013

Among patients with painful chemotherapy-induced peripheral neuropathy, use of the anti-depressant drug duloxetine for 5 weeks resulted in a greater reduction in pain compared with placebo, according to a study in the April 3 issue of JAMA.

"Approximately 20 percent to 40 percent of patients with cancer who receive neurotoxic chemotherapy (e.g., taxanes, platinums, vinca alkaloids, bortezomib) will develop painful chemotherapy-induced peripheral neuropathy. Painful chemotherapy-induced neuropathy can persist from months to years beyond chemotherapy completion, causing significant challenges for cancer survivors due to its negative influence on function and quality of life. Chemotherapy-induced peripheral neuropathy is difficult to manage, and most randomized controlled trials testing a variety of drugs with diverse mechanisms of action revealed no effective treatment," according to background information in the article.

There is evidence that serotonin and norepinephrine dual reuptake inhibitors are effective in treating neuropathy-related pain. Several phase 3 studies have shown that duloxetine is an effective treatment for painful diabetic neuropathy.

Ellen M. Lavoie Smith, Ph.D., of the University of Michigan School of Nursing, Ann Arbor, and colleagues conducted a randomized phase 3 trial to examine whether duloxetine would lessen chemotherapy-induced peripheral neuropathic pain. The study included 231 patients who were 25 years or older being treated at community and academic settings between April 2008 and March 2011. Study follow-up was completed July 2012. Stratified by chemotherapeutic drug and comorbid pain risk, patients were randomized to receive either duloxetine followed by placebo or placebo followed by duloxetine. Eligibility required that patients have a pain score of at least 4 on a scale of 0 to 10, representing average chemotherapy-induced pain, after paclitaxel, other taxane, or oxaliplatin treatment.


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Contact: Nicole Fawcett
nfawcett@umich.edu
734-764-2220
The JAMA Network Journals
Source:Eurekalert

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