A 5-week course of daily oral duloxetine reduced pain and improved function and quality of life for patients with chemotherapy-induced peripheral neuropathy, according to a report in the April 3 issue of JAMA.
Duloxetine’s effects on chemotherapy-induced peripheral neuropathic pain were measured in a randomized, double-blind, placebo-controlled, crossover clinical trial involving 231 cancer patients aged 25 years and older who had been treated with platinum or taxane agents. Study subjects were approximately twice as likely to experience a 30% reduction in pain while taking duloxetine than while taking placebo and were 2.4 times more likely to experience a 50% reduction in pain, said Ellen M. Lavoie Smith, Ph.D., of the University of Michigan School of Nursing, Ann Arbor, and her associates. The data were presented at the 2012 annual meeting of the American Society of Clinical Oncology.
Patients also reported better daily functioning with duloxetine, compared with placebo, including improved scores on measures assessing numbness, tingling, or discomfort of the hands or feet; tinnitus or difficulty hearing; joint pain; muscle cramps and weakness; and difficulty walking, dressing, or feeling small objects in the hands. Pain-related quality of life also improved to a greater degree with duloxetine (mean change of 2.44 points out of 44 possible points on the Functional Assessment of Cancer Treatment, Gynecologic Oncology Group Neurotoxicity subscale) than with placebo (mean change of 0.87 points).
There were no hematologic or grade 4 adverse events. Mild adverse events were reported by 16% during duloxetine treatment and 27% during placebo treatment, and moderate adverse effects were reported by 7% and 3%, respectively. These included fatigue, insomnia, and nausea in both patient groups, the investigators said (JAMA 2013;309:1359-67).
This study was supported by the National Cancer Institute and the Alliance Statistics and Data Center. Study drugs and placebo were supplied by Eli Lilly. Dr. Smith reported no conflicts of interest, and one of her associates reported ties to Genentech.