New Tool Suggests Dominance of Non-Painful Symptoms in Peripheral Neuropathy
Scientists have developed a new tool for the assessment of chemotherapy-induced peripheral neuropathy.
Scientists have developed a new tool for the assessment of chemotherapy-induced peripheral neuropathy (CIPN), according to research published in the October 2015 issue of The Journal of Pain.1
The Treatment-Induced Neuropathy Assessment Scale (TNAS) is a brief yet comprehensive patient-reported outcome (PRO) measure that captures the multifaceted nature of neuropathy, distinguishing pain from non-painful aspects such as numbness and tingling.
Researchers evaluating TNAS in patients with multiple myeloma (MM) and colorectal cancer (CRC) undergoing neurotoxic therapies found that both groups rated the severity of numbness/tingling significantly higher than that of pain.
“Our current understanding of neuropathy indicates that pain is only one of its components, and often it is not the most distressing aspect of neuropathy to patients…the nonpainful component of neuropathy may be more disabling than the pain component,” write Tito R. Mendoza, PhD, MS, MEd, and colleagues from the University of Texas MD Anderson Cancer Center in Houston.
Current PROs Fail to Distinguish Between Neuropathy and Neuropathic Pain
CIPN has traditionally been assessed using a combination of objective tests, clinician evaluation and subjective patient reports — an approach that is often not logically feasible, especially in the context of multisite trials, the authors write. Neurophysiological testing, though objective, is complicated and expensive — and as with clinician-rated CIPN, study results correlate only moderately with patient reports of symptoms.
“The driving force behind this research is the need to validly and reliably assess neuropathy, especially when there are logistical concerns such as those found in multisite studies. The current practice of using a combination of clinical exam, clinician ratings and patient ratings are inefficient especially if there are multiple sites involved in a study. Using a standardized instrument facilitates comparison of study results and helps to minimize variability in data collection across study sites,” Dr. Mendoza told Clinical Pain Advisor.