Chemotherapy-induced peripheral neuropathy (CIPN)

Licht, Thomas; Kéilani, Mohammad; Crevenna, Richard

doi:10.1007/s12254-021-00688-3

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…While previous review articles22–26 and guideline articles27–29 expressed promise surrounding duloxetine, our review found that there was a modest trend for pain reduction and a trend in increased adverse effects is also present. It is not clear from the data thus far that duloxetine should be routinely recommended in practice for CIPN treatment, and there are limited available data on its use for CIPN.…”

Section: Discussioncontrasting

confidence: 57%

Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis

Chow

Novosel

et al. 2022

BMJ Support Palliat Care

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IntroductionDuloxetine has previously been reported to be promising in the setting of chemotherapy-induced peripheral neuropathy (CIPN). The aim of this study was to conduct a comprehensive systematic review and meta-analysis, on the use of duloxetine in prevention and treatment of CIPN.MethodsPubMed, Embase and Cochrane CENTRAL were searched from database inception up until April 2022. Articles were included in this review if they reported on duloxetine use in the setting of CIPN, in a multiarm comparative human trial. A random effects DerSimonian-Laird model was used to calculate summary risk ratios (RR) and corresponding 95% CIs, comparing duloxetine to placebo. This review was registered on.ResultsSeven randomised controlled trials that included 645 patients were identified. Five reported on duloxetine for treatment of CIPN, and two for prevention of CIPN. Two studies had some concern for bias. Duloxetine was statistically similar to placebo in its efficacy, both in the treatment (RR 0.92, 95% CI 0.84 to 1.01) and prevention (RR 1.02, 95% CI 0.87 to 1.19) of CIPN. Safety profile was similar, in the treatment (RR 1.31, 95% CI 0.90 to 1.89) and prevention (RR 1.52, 95% CI 0.98 to 2.38) setting.ConclusionThere is currently limited evidence supporting duloxetine’s use for CIPN. There is a need for more comprehensive and higher-quality trials assessing duloxetine in the setting of CIPN, before further clinical practice recommendations.Trial registration numberPROSPERO (CRD42022327487).

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Section: Discussioncontrasting

confidence: 57%

Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis

Chow

Novosel

et al. 2022

BMJ Support Palliat Care

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“…Most of the research and practice guidelines on CIPN management focus on pharmacological prevention and/or treatment with no definitive evidence on effectiveness of any neuroprotectors or treatment modalities [55–57]. There is limited research on the non‐pharmacological CIPN management involving allied health care professionals and unfortunately, none of the research or current guidelines include podiatry care as a part of CIPN management [13, 19, 28, 58]. There are several CIPN related lower limbs consequences that can impact the quality of life of cancer survivors such as increased falls risks due to reduced proprioception, affected balance, gait, mobility and functionality, and increased risk of development of ulcerations due to changes in sensation [17, 19, 20, 51].…”

Section: Discussionmentioning

confidence: 99%

“…Alternate and adjunct treatments suggested by a few podiatrists in the panel which didn't reach agreement included cryotherapy, scrambler therapy, acupuncture and massage therapy. Given the lack of or low‐quality evidence for their effectiveness [13, 19, 28, 55] such therapies are not currently recommended as part of the standard care. However, further research into their potential is needed so that more comprehensive guidelines for effective treatment can be developed in future to ensure optimal care of people with CIPN by the podiatrists.…”

Section: Discussionmentioning

confidence: 99%

“…Sensory neuropathy is frequently associated with deterioration in lower limb health and overall quality of life for cancer survivors [17]. Specifically, CIPN can present as a loss of protective sensation in feet leading to ulcerations and in the some cases, amputation [18]; reduced proprioception leading to ataxic gait and increased risk of falls [19,20]; neuralgia (nerve pain including numbness, allodynia and tingling) presenting in a "glove and stocking" pattern [15,21]; changes in skin integrity leading to dermatological problems such as blistering, skin crusting and peeling, hyperkeratosis and changes in sweat production [22]; and changes in nails presenting as pathologies like onychocryptosis (ingrown toenail), paronychia (infection around nail), onycholysis (separation of nail from nail bed) and cessation of nail growth with 'unsightly' dystrophic changes [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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Development of the consensus‐based recommendations for Podiatry care of Neuropathy In Cancer Survivors (PodNICS): a Delphi consensus study of Australian podiatrists

Dars

Buckley

Beckmann

et al. 2023

Journal of Foot and Ankle Research

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Background Chemotherapy Induced Peripheral Neuropathy (CIPN) is the most common presenting side effect of chemotherapy. As a sensory based neuropathy, this condition can persist for a long time after cessation of chemotherapy and impact the quality of life of cancer survivors. Podiatrists in Australia have been managing people with CIPN related lower limb complications, however guidelines on management of CIPN do not exist. The aim of this study was to achieve consensus and agreement of Australian podiatrists on strategies to best manage people presenting with symptoms of CIPN. Methods An online three-round modified Delphi survey of Australian podiatrists with expertise in CIPN was conducted in line with recommendations for conducting and reporting of Delphi studies (CREDES). Panellists responded to open-ended questions in Round 1, whereupon their responses were themed into statements and analysed for existing consensus. Statements not reaching consensus were returned during Round 2 to seek agreement from responders using a five-point Likert scale and to allow responders to make further comments. For a statement to reach consensus or agreement, 70% or more of panellists needed to make the same comment or agree or strongly agree with the same themed statement. Statements reaching 50 to 69% consensus or agreement were returned to panellists in Round 3 for them to consider their responses in the light of group outcomes. Results Round one resulted in 229 comments from 21 of 26 podiatrists who agreed to participate. These comments were themed into 53 statements with 11 consensus statements accepted. Round 2 resulted in 22 statements reaching agreement, and 15 new statements being generated from 18 comments made by 17 respondents. Round 3 resulted in 11 statements reaching agreement. Outcomes were developed into a set of clinical recommendations for diagnosis and management of people presenting with CIPN. These recommendations provide guidance on 1) identifying common signs and symptoms of CIPN including sensory, motor and autonomic symptoms; 2) diagnosis and assessment of CIPN including neurological, motor and dermatological assessment modalities; and 3) best clinical practice and management strategies for CIPN identified by podiatrists including both podiatry and non-podiatry specific care. Conclusions This is the first study in podiatry literature to develop expert-informed consensus-based recommendations for clinical presentation, diagnosis and assessment and management of people with CIPN. These recommendations aim to help guide podiatrists in the consistent care of people with CIPN.

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“…However, there have not been working agents or clinical protocols to effectively stop and reverse CIPN. Although the mechanisms of CIPN are not known entirely, growing evidence confirms that paclitaxel administration improves sensitivity to mechanical and cold stimuli (mechanical and cold allodynia) targeting peripheral sensory neurons in the dorsal root ganglia (DRGs), which leads to oxidative stress and neuroinflammation, resulting in degeneration of intraepidermal nerve fiber density [17], [18]. Here, we share natural history of the application of paclitaxel chemotherapy to a patient along with successful management for removing the P-APS.…”

Section: Introductionmentioning

confidence: 95%

Natural History of Paclitaxel-associated Acute Pain Syndrome: A Case Report of Rare Side Effect of Paclitaxel

Salima

Harsono

Aisyah

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: One of the harshest side effects following anticancer agent treatments is chemotherapy-induced neuropathic pain. After surgical staging, chemotherapy combination of paclitaxel carboplatin could be a choice of therapy for Stage II or more advanced stage of ovarian cancer. Different side effects may appear after the application of paclitaxel. CASE REPORT: Here, we show an uncommon case of paclitaxel-acute pain syndrome (P-APS), and how we deal with such cases according to our experiences. One uncommon side effect is P-APS, which can be treated effectively with the administration of non-steroidal anti-inflammatory drugs, corticosteroid, and supportive therapy. CONCLUSION: One uncommon side effect of Paclitaxel induced neuropathic can be treated effectively with the administration of non-steroidal anti inflammatory drugs, corticosteroid, and supportive therapy.

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Chemotherapy-induced peripheral neuropathy (CIPN)

Cited by 4 publications

References 28 publications

Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis

Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis

Development of the consensus‐based recommendations for Podiatry care of Neuropathy In Cancer Survivors (PodNICS): a Delphi consensus study of Australian podiatrists

Natural History of Paclitaxel-associated Acute Pain Syndrome: A Case Report of Rare Side Effect of Paclitaxel

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