Study: Vitamin E protects patients from cisplatin-induced neuropathy in a randomized trial

Dr. Friedrich Schmidt

Transparenz: Redaktionell erstellt und geprüft.
Veröffentlicht am 21.08.2023

Sprache:

In der folgenden Studie geht es um die Untersuchung der möglichen neuroprotektiven Wirkung von Vitamin E bei Cisplatin-induzierter Neuropathie. Es handelt sich um eine randomisierte, doppelblinde Interventionsstudie, bei der ursprünglich 108 Patienten randomisiert wurden, von denen 41 mit einer Cisplatin-Dosis von mehr als 300 mg/m2 behandelt wurden. Die Probanden erhielten entweder täglich 596 IE d-alpha-Tocopherol (Vitamin E) oder ein Placebo, beginnend 1 bis 8 Tage vor Beginn der Cisplatin-Therapie und für 3 Monate nach Beendigung der Therapie. Der Zielparameter war die Entwicklung einer peripheren Neuropathie und die Schwere der neurologischen Schädigung wurde mit dem Gesamtneuropathiescore (TNS) gemessen. Die Ergebnisse zeigten, … — The following study is about investigating the possible neuroprotective effect of vitamin E in cisplatin-induced neuropathy. This is a randomized, double-blind interventional study that initially randomized 108 patients, 41 of whom were treated with a dose of cisplatin greater than 300 mg/m2. Subjects received either 596 IU of d-alpha-tocopherol (vitamin E) or placebo daily starting 1 to 8 days before starting cisplatin therapy and for 3 months after cessation of therapy. The outcome measure was the development of peripheral neuropathy and the severity of neurological damage was measured with the total neuropathy score (TNS). The results showed...

The following study is about investigating the possible neuroprotective effect of vitamin E in cisplatin-induced neuropathy. This is a randomized, double-blind interventional study that initially randomized 108 patients, 41 of whom were treated with a dose of cisplatin greater than 300 mg/m2. Subjects received either 596 IU of d-alpha-tocopherol (vitamin E) or placebo daily starting 1 to 8 days before starting cisplatin therapy and for 3 months after cessation of therapy. The outcome measure was the development of peripheral neuropathy and the severity of neurological damage was measured with the total neuropathy score (TNS). Results showed that the vitamin E group had significantly lower rates of neurotoxicity (6% vs. 42%) and lower severity of neurological damage (1.4 TNS vs. 4.1). These results suggest that vitamin E may provide protection against cisplatin-induced neuropathies and patients receiving cisplatin should be treated with vitamin E supplements several days before starting chemotherapy.

Details of the study:

reference

Pace A, Giannarelli D, Galie E, et al. Vitamin E neuroprotection in cisplatin neuropathy.Neurology.2010;74:762-766.

design

Randomized, double-blind intervention study

Participant

Of the 108 patients originally randomized into the study, 41 were treated with more than 300 mg/m2 of cisplatin. Of these 41 subjects, 17 had received vitamin E and 24 had received a placebo.

Study medications and dosage

596 IU d-alpha-tocopherol or placebo daily, started 1 to 8 days before initiation of cisplatin therapy and continued for 3 months after discontinuation of cisplatin therapy

Target parameters

Development of peripheral neuropathy as a result of cisplatin therapy and measurement of the severity of neurological damage using the total neuropathy score (TNS)

Key findings

Neurotoxicity occurred in 6% in the vitamin E group versus 42% in the placebo group (P<0.01). The severity of neurological damage was also significantly lower in the vitamin E group (1.4 TNS vs. 4.1;P<0.01).

Effects on practice

The use of cisplatin is limited by severe neurotoxicity. According to some reports, when the cumulative dose exceeds 300 mg/m2, significant neurological damage occurs in most patients. Cisplatin is known to increase oxidative stress; Vitamin E is an antioxidant, and current evidence suggests that the antioxidant effects of vitamin E do not interfere with the therapeutic effect of chemotherapy.¹Neuropathy has been reported to occur in the setting of vitamin E deficiency. Therefore, researchers are interested in studying vitamin E's ability to protect against cisplatin-induced neuropathies.

Researchers are interested in exploring vitamin E's ability to protect against cisplatin-induced neuropathies.

In 2007, a Cochrane review concluded that previous evidence linking vitamin E use to protection against neuropathy in patients given cisplatin was encouraging but needed additional support from randomized clinical trials.²The results of the new study take us a significant step in this direction. Until more information is available, all patients receiving cisplatin should take concurrent vitamin E supplements several days before starting chemotherapy.

Study: Vitamin E protects patients from cisplatin-induced neuropathy in a randomized trial

Details of the study:

reference

design

Participant

Study medications and dosage

Target parameters

Key findings

Effects on practice

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