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 .
Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel.
e20505 Background : Neuropathic pain ( NP ) remains difficult to control for a significant proportion of patients with cancer . Chemotherapy induced peripheral neuropathy ( CIPN ) is postulated as an initial stage to the development of NP . Among breast cancer patients , taxanes , platinum agents , and vinca alkaloids are most likely to cause NP . The purpose of this study was to assess the extent to which those who experienced CIPN ( NCI toxicity criteria ≥ grade 2 sensory neuropathy ) during paclitaxel chemotherapy were at risk of developing chronic NP , controlling for disease- and treatment-related variables ( e.g. , stage of disease , location of tumor chemotherapy and other cancer therapies , dose of chemotherapy and duration of treatment ) , clinical health status ( e.g. , comorbid conditions ) , and sociodemographic characteristics ( e.g. , age , race ) . METHODS We conducted a follow-up survey of breast cancer patients who previously participated in clinical trials for paclitaxel .  Patients were asked if they have ever been diagnosed by the physician or healthcare provider for NP during the survey . Clinical trial data ( NCI Toxicity , cummulative dose ) were abstract ed from a clinical data base . RESULTS Of the 430 potential respondents , 240 responded to the survey . Mean follow-up time was 9.5 years ( SD=2.1 ) . Sixty three percent of the respondents had grade 2 or greater sensory neuropathy during their previous treatment with paclitaxel . Follow-up data showed that 18 % ( 43/240 ) were subsequently diagnosed by their physician to have NP . Logistic regression analysis showed that those with CIPN during the trial were 3 times more likely to having been diagnosed with NP ( OR=3 ; 95%CI=1.2 ; 7.2 ; p<0.001 ) , which persisted in the multivariable model . Other variables found to be associated with NP included cummulative dose of paclitaxel , and comorbid conditions such as diabetes and osteoarthritis . Patients with NP reported twice as many visits to their health care provider ( p=0.028 ) ; had taken more prescription ( 50 % versus 19 % ; p=0.0001 ) for pain relative to those without NP . CONCLUSIONS We provide empirical evidence on the importance CIPN as a risk factor for NP in breast cancer patients . Prospect i ve studies with larger cohorts are needed to vali date our findings . No significant financial relationships to disclose
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 .