Electroacupuncture for thalidomide/bortezomib-induced peripheral neuropathy in multiple myeloma: a feasibility study

Abstract

BackgroundThis single-arm study evaluated feasibility, safety, and initial efficacy of electroacupuncture for thalidomide/bortezomib-induced peripheral neuropathy (PN) in cancer patients with multiple myeloma.MethodsPatients with neuropathy ≥ grade 2 received 20 acupuncture treatments over 9 weeks.ResultsFor the 19 evaluable patients, Functional Assessment of Cancer Therapy/Gynecological Oncology Group-Neurotoxicity (FACT/GOG/NTX) mean (SD) scores improved significantly between baseline and week 13 (20.8 [9.6] vs 13.2 [8.5], p = 0.0002). Moderate effect size differences began on week 4, with the largest effect size differences found at week 9 for FACT/GOG/NTX scores, worst pain in the last 24 hours, and pain severity (Cohen’s d = 1.43, 1.19, and 1.08, respectively) and continuing through week 13 (Cohen’s d = 0.86, 0.88, and 0.90, respectively). From baseline to week 13, additional significant improvements were seen as follows: postural stability (1.0 [0.6] vs 0.8 [0.4], p = 0.02); coin test (10.0 [7.4] vs 5.6 [1.9], p < 0.0001); button test (96.1 [144.4] vs 54.9 [47.3], p < 0.0001); and walking test (21.6 [10.0] vs 17.2 [7.7], p = 0.0003). No significant changes were seen with NCS.ConclusionsAcupuncture may help patients experiencing thalidomide- or bortezomib-induced PN. Larger, randomized, clinical trials are needed.Trial registrationClinicalTrials.gov Identifier: NCT00891618.

Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review

“…In another pilot study by Bao et al [66], 27 multiple myeloma patients with moderate to severe bortezomib-induced peripheral neuropathy experienced significantly reduced neuropathic pain and improved functioning following 10 weeks of acupuncture treatment (twice weekly for 2 weeks, once weekly for 4 weeks, and then biweekly for 4 weeks). Another single-arm study by Garcia et al [67] demonstrated that electroacupuncture was safe and possibly effective in treating thalidomide/bortezomib-induced peripheral neuropathy in 19 multiple myeloma patients with significant improvements in Functional Assessment of Cancer therapy-neurotoxicity score after 9 weeks treatment. The intervention was conducted over a 9-week period of 20 acupuncture sessions at 2–3 times weekly.…”

Vinca alkaloids, thalidomide and eribulin‐induced peripheral neurotoxicity: From pathogenesis to treatment

“…Additional management strategies include use of supportive care medications such as gabapentin, pregabalin, and tricyclics as well as duloxetine, which has the strongest phase III data supporting its use (although not specifically for these chemotherapy classes) . One feasibility study with electroacupuncture in patients experiencing thalidomide or bortezomib‐induced peripheral neuropathy showed promising results which will need to be replicated in a randomized larger study . Several additional small trials have also investigated the benefits of neuropathy in CIPN due to various agents with inconsistent methodologies and results although it does appear that this intervention can be helpful to some patients .…”

Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma

“…In addition, a case series has proven the efficacy of body acupuncture in treating patients with CIPN [20], and a pilot study demonstrated that acupuncture improved nerve conduction in peripheral neuropathy [21]. In recent studies, statistically and clinically significant reductions in subjective measurements of bortezomib-induced peripheral neuropathy (BIPN) were observed after acupuncture treatment [22, 23]. However, to date, there have been no randomized controlled clinical research to analyze the effectiveness of acupuncture in treating CIPN of MM patients.…”