Duloxetine relieves chemotherapy-related neuropathy

The antidepressant duloxetine (Cymbalta ®) can effectively treat chemotherapy-induced neuropathy in some patients , researchers reported on July 3, 2012 at the American Society of Clinical Oncology Annual Meeting.

“In addition to improving symptoms and quality of life, treating peripheral neuropathy pain potentially improves quantity of life if it helps patients avoid decreasing their chemotherapy medications,” said lead study author Ellen M. Lavoie Smith, Ph.D., APRN, assistant professor at the University of Michigan School of Nursing in Ann Arbor and a researcher at the University of Michigan Comprehensive Cancer Center.

As background, the investigators noted that while chemotherapy-induced peripheral neuropathy is uncomfortable, and it becomes painful in approximately 30 percent of neuropathy patients. The condition can limit chemotherapy dosing if the pain is too severe. There is no effective treatment available.

In prior studies, duloxetine has already shown efficacy against painful diabetic neuropathy.

The researchers enrolled 231 patients who reported painful neuropathy after chemotherapy with  oxaliplatin or paclitaxel. They randomized the subjects to receive duloxetine or a placebo for five weeks, and the subjects reported weekly on pain levels.

Subjects received 30 milligrams a day during the first week and were titrated up to a full dose of 60 mg daily for four more weeks.

The researchers reported that 59 percent of subjects who received duloxetine reported pain reduction, compared to 39 percent of placebo subjects. The most common side effect was fatigue

“These drugs don’t work in everyone. The good news is it worked in the majority of patients. We need to figure out who are the responders. If we can predict who they are, we can target the treatment to the people it’s going to work for,” Smith said.

The study was funded by the (USA) National Institutes of Health’s National Cancer Institute. Drugs and placebo provided were by Lilly Pharmaceuticals.

Reference: “CRA9013: CALGB 170601: A phase III double blind trial of duloxetine to treat painful chemotherapy-induced peripheral neuropathy (CIPN),” Smith et al. American Society of Clinical Oncology Annual Meeting, June 1-5, 2012