The effect of pregabalin and duloxetine treatment on quality of life of breast cancer patients with taxane?induced sensory neuropathy: A randomized clinical trial
Abstract
Background: The primary side effect of adjuvant chemotherapy with taxanes is the taxane?induced peripheral neuropathy (TIPN),
which may have substantial negative impacts on patients’ quality of life (QOL). We investigated the effect of pregabalin and duloxetine
on QOL of breast cancer patients who experienced TIPN. Materials and Methods: This was a randomized, double?blind clinical
trial conducted at a chemotherapy center of Mazandaran University of Medical Sciences, Sari, Iran. Breast cancer patients 18 or more
years old were included if they received paclitaxel or docetaxel and experienced neuropathy grade one or higher; and neuropathic
pain score of four or more. Patients were treated with pregabalin or duloxetine until 6 weeks. Assessment of sensory neuropathy and QOL was performed at baseline, and 6 weeks after the initiation of the treatment. Results: At baseline, the mean score of global health status/QOL scale for pregabalin and duloxetine groups were 61 (standard deviation [SD]; 5.11) and 60.28 (SD; 5.44), respectively (P = 0.54). After 6 weeks, both nterventions were associated with improvement of global QOL compared to baseline. The global health status/QOL score was not different between two groups after 6 weeks. While the emotional functioning was improved more favorably with duloxetine (P < 0.001); pregabalin was associated with more improvement in insomnia and pain scores (P = 0.05 and P < 0.001, espectively). Conclusion: Pregabalin as well as duloxetine improve the global QOL of breast cancer patients with TIPN. Different effects of reatments on subscale of QLQ?C30 could help clinicians to select the appropriate agent individually.
which may have substantial negative impacts on patients’ quality of life (QOL). We investigated the effect of pregabalin and duloxetine
on QOL of breast cancer patients who experienced TIPN. Materials and Methods: This was a randomized, double?blind clinical
trial conducted at a chemotherapy center of Mazandaran University of Medical Sciences, Sari, Iran. Breast cancer patients 18 or more
years old were included if they received paclitaxel or docetaxel and experienced neuropathy grade one or higher; and neuropathic
pain score of four or more. Patients were treated with pregabalin or duloxetine until 6 weeks. Assessment of sensory neuropathy and QOL was performed at baseline, and 6 weeks after the initiation of the treatment. Results: At baseline, the mean score of global health status/QOL scale for pregabalin and duloxetine groups were 61 (standard deviation [SD]; 5.11) and 60.28 (SD; 5.44), respectively (P = 0.54). After 6 weeks, both nterventions were associated with improvement of global QOL compared to baseline. The global health status/QOL score was not different between two groups after 6 weeks. While the emotional functioning was improved more favorably with duloxetine (P < 0.001); pregabalin was associated with more improvement in insomnia and pain scores (P = 0.05 and P < 0.001, espectively). Conclusion: Pregabalin as well as duloxetine improve the global QOL of breast cancer patients with TIPN. Different effects of reatments on subscale of QLQ?C30 could help clinicians to select the appropriate agent individually.
Keywords
Duloxetine, neuropathy, pregabalin, quality of life, taxanes