Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
Preventing paclitaxel-induced peripheral neuropathy: a phase II trial of vitamin E supplementation.
A r and omized , controlled trial was performed to assess the efficacy and safety of vitamin E supplementation for prophylaxis against paclitaxel-induced peripheral neuropathy ( PIPN ) .  Thirty-two patients undergoing six courses of paclitaxel-based chemotherapy  were r and omly assigned to receive either chemotherapy with vitamin E ( 300 mg twice a day , Group I ) or chemotherapy without vitamin E supplementation ( Group II ) . A detailed neurological examination and electrophysiological study was performed during and 3 months after chemotherapy . The severity of PIPN was summarized by means of a modified Peripheral Neuropathy ( PNP ) score . The incidence of neurotoxicity differed significantly between groups , occurring in 3/16 ( 18.7 % ) patients assigned to the vitamin E supplementation group and in 10/16 ( 62.5 % ) controls ( P=0.03 ) . The relative risk ( RR ) of developing PIPN was significantly higher in controls than in vitamin E group patients ( RR=0.3 , 95 % confidence interval (CI)=0.1 - 0.9 ) . Mean PNP scores were 2.25+/-5.1 ( range 0 - 15 ) for patients in Group I and 11+/-11.63 ( range 0 - 32 ) for those in Group II ( P=0.01 ) . Vitamin E supplementation was well tolerated and showed an excellent safety profile . This study shows that vitamin E effectively and safely protects patients with cancer from the occurrence of paclitaxel-induced peripheral nerve damage . A double-blind , placebo-controlled trial is needed to confirm these results
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .