Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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Neuropathic Pain Care
Which treatments are effective for neuropathic pain care? Almost 40% of myeloma patients experience CIPN, according to research.
This occurrence rate is complicated because:
- Many MM patients develop nerve pain in their hands and feet due to the cancer itself-
- Many MM patients don’t experience CIPN at first, but do later in there therapy-
- Many MM patients experience CIPN initially but it can go away as a result of a therapy break or a reduction of therapy.
I am a long-term MM survivor. I’ve read and written about CIPN many times over the years. CIPN is one of the most debilitating side effects of chemotherapy that I know of. Online MM groups are filled with questions from MM patients struggling with CIPN.
When new therapies are studied and written about, I blog about them.
Doctor Explains Chemotherapy-Induced Peripheral Neuropathy
If you are a newly diagnosed MM patient and have not yet begun your induction therapy, consider undergoing preventative therapies before you begin any chemo regimens. At the first sign of CIPN, talk to your oncologist about reducing the therapy or even taking a therapy vacation.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about managing your MM as well as your side effects with both conventional and non-conventional treatments.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Which Treatments Lead Neuropathic Pain Care?
TOPLINE:
A meta-analysis of 313 trials found that tricyclic antidepressants (TCAs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and alpha-2-delta ligands offered modest efficacy for neuropathic pain and were recommended as first-line treatments. Capsaicin 8% patches, capsaicin cream, and lidocaine 5% plasters were recommended as second-line treatments, and botulinum toxin type A, repetitive transcranial magnetic stimulation (rTMS), and opioids were recommended as third-line treatments.
METHODOLOGY:
- Researchers conducted systematic searches in Embase, PubMed, the International Clinical Trials Registry, and ClinicalTrials.gov.
- A total of 313 trials (284 pharmacologic and 29 neuromodulation studies) were analysed, comprising 48,789 adults treated for neuropathic pain.
- The primary efficacy outcome was the proportion of participants achieving at least 50% or 30% reduction in baseline pain intensity or moderate pain relief, and the primary safety outcome was the number of participants who withdrew from treatment due to adverse events.
- Nine neuromodulation and 89 pharmacologic interventions were assessed. For each treatment, risk differences were used to determine the number needed to treat (NNT) and the number needed to harm (NNH).
TAKEAWAY:
- Strong recommendations were made for the use of TCAs (NNT, 4.6; NNH, 17.1; moderate certainty of evidence), alpha-2-delta ligands (NNT, 8.9; NNH, 26.2; moderate certainty of evidence), and SNRIs (NNT, 7.4; NNH, 13.9; moderate certainty of evidence) as first-line treatments.
- Weak recommendations were made for the use of capsaicin 8% patches (NNT, 13.2; NNH, 1129.3; moderate certainty of evidence), capsaicin cream (NNT, 6.1; NNH, 18.6; very low certainty of evidence), and lidocaine 5% plasters (NNT, 14.5; NNH, 178.0; very low certainty of evidence) as second-line treatments.
- Furthermore, weak recommendations were made for the use of botulinum toxin type A (NNT, 2.7; NNH, 216.3; moderate certainty of evidence), rTMS (NNT, 4.2; NNH, 651.6; low certainty of evidence), and opioids (NNT, 5.9; NNH, 15.4; low certainty of evidence) as third-line treatments.
IN PRACTICE:
“The recommendations highlight the need for shared decision making, prioritising patient autonomy and preferences when tailoring treatment strategies. Health-care professionals should adapt these guidelines to their specific contexts, accounting for the cost, accessibility, and feasibility of treatments,” the authors wrote, emphasizing the need for further “placebo-controlled or sham-controlled trials done over clinically relevant timeframes.”
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