Medication duloxetine helps reduce pain from chemotherapy

April 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, ) will develop painful chemotherapy-induced peripheral neuropathy. Painful chemotherapy-induced neuropathy can persist from months to years beyond chemotherapy completion, causing significant challenges for due to its on function and quality of life. Chemotherapy-induced peripheral neuropathy is difficult to manage, and most 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 is an effective treatment for painful .

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 of at least 4 on a scale of 0 to 10, representing average chemotherapy-induced pain, after , other taxane, or treatment.

The initial treatment consisted of taking 1 capsule daily of either 30 mg of duloxetine or placebo for the first week and 2 capsules of either 30 mg of duloxetine or placebo daily for 4 additional weeks.

The researchers found that at the end of the initial treatment period, patients in the duloxetine-first group reported a larger decrease in average pain (average change score, 1.06) than those in the placebo-first group (average change score 0.34). The observed average difference in the average pain score between the duloxetine-first and placebo-first groups was 0.73. Of the patients treated with duloxetine first, 59 percent reported any decrease in pain vs. 38 percent of patients treated with placebo first. Thirty percent of duloxetine-treated patients reported no change in pain and 10 percent reported increased pain.

The authors note that the results suggested that patients who received platinums (oxaliplatin) may have experienced more benefit from duloxetine than those who received taxanes.

Pain-related quality-of-life improved to a greater degree for those treated with duloxetine during the initial treatment than for those treated with placebo.

"In conclusion, 5 weeks of duloxetine treatment was associated with a statistically and clinically significant improvement in pain compared with placebo. Exploratory analyses raise the possibility that duloxetine may work better for oxaliplatin-induced rather than taxane-induced painful chemotherapy-induced peripheral neuropathy," the researchers write.

Explore further: Antidepressant helps relieve pain from chemotherapy, study finds

More information: JAMA. 2013;309(13):1359-1367

Related Stories

Antidepressant helps relieve pain from chemotherapy, study finds

June 4, 2012
The antidepressant drug duloxetine, known commercially as Cymbalta, helped relieve painful tingling feelings caused by chemotherapy in 59 percent of patients, a new study finds. This is the first clinical trial to find an ...

Drugs similar in efficacy for neuropathic pain in diabetes

September 26, 2012
(HealthDay)—In the treatment of patients with chronic diabetic peripheral neuropathic pain (DPNP), there are no significant differences in pain-relief efficacy between amitriptyline, duloxetine, and pregabalin; however, ...

Antidepressant proves effective in alleviating osteoarthritis pain

March 22, 2012
Antidepressants can play a key role in alleviating painful conditions like osteoarthritis and may result in fewer side effects than traditionally prescribed drug regimes, such as anti-inflammatories and opioids, according ...

Low-dose duloxetine deemed safe for urinary incontinence

July 27, 2012
(HealthDay) -- Duloxetine appears safe for the routine clinical care of women with stress urinary incontinence (SUI), according to a study published online July 23 in the British Journal of Clinical Pharmacology.

Acupuncture may ease severe nerve pain associated with cancer treatment

December 6, 2011
Acupuncture may help ease the severe nerve pain associated with certain cancer drugs, suggests a small preliminary study published in Acupuncture in Medicine.

Recommended for you

Long-sought mechanism of metastasis is discovered in pancreatic cancer

July 27, 2017
Cells, just like people, have memories. They retain molecular markers that at the beginning of their existence helped guide their development. Cells that become cancerous may be making use of these early memories to power ...

Researchers release first draft of a genome-wide cancer 'dependency map'

July 27, 2017
In one of the largest efforts to build a comprehensive catalog of genetic vulnerabilities in cancer, researchers from the Broad Institute of MIT and Harvard and Dana-Farber Cancer Institute have identified more than 760 genes ...

Cancer-death button gets jammed by gut bacterium

July 27, 2017
Researchers at Michigan Medicine and in China showed that a type of bacterium is associated with the recurrence of colorectal cancer and poor outcomes. They found that Fusobacterium nucleatum in the gut can stop chemotherapy ...

Manmade peptides reduce breast cancer's spread

July 27, 2017
Manmade peptides that directly disrupt the inner workings of a gene known to support cancer's spread significantly reduce metastasis in a mouse model of breast cancer, scientists say.

Blocking the back-door that cancer cells use to escape death by radiotherapy

July 27, 2017
A natural healing mechanism of the body may be reducing the efficiency of radiotherapy in breast cancer patients, according to a new study.

Glowing tumor technology helps surgeons remove hidden cancer cells

July 27, 2017
Surgeons were able to identify and remove a greater number of cancerous nodules from lung cancer patients when combining intraoperative molecular imaging (IMI) - through the use of a contrast agent that makes tumor cells ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.