Methadone to Treat Painful Chemotherapy-induced Peripheral Neuropathy
Status:
Not yet recruiting
Trial end date:
2024-08-01
Target enrollment:
Participant gender:
Summary
Chemotherapy induced peripheral neuropathy (CIPN) is a painful and disabling nerve pain that
can be caused from common types of chemotherapy used to treat cancer. It can affect up to 70%
of people who receive chemotherapy for months or even life-long. CIPN causes
"glove-and-stocking" distribution of nerve-pain, weakness, lower quality of life, lower
ability to do day to day tasks such as walking and writing, and other symptoms.
Duloxetine is the only recommended medication by national and international groups such as
the American Society of Oncology to treat painful CIPN. However, studies show it only has
small benefit; for example, the largest study showed it only reduces pain by 0.73 out of 10
points compared to placebo.
Another promising medication in theory and practice is methadone. It is a very well studied
and commonly used pain medication from a class called opioids. However, it does have unique
qualities that make it more effective to treat nerve pain when compared to other opioids like
morphine and fentanyl. Furthermore, studies show it may develop less tolerance in the body
over time when compared to other opioids; this is helpful as many develop lifelong CIPN and
therefore may benefit from lifelong pain medication. Methadone has not been studied in CIPN.
This study is a pilot clinical trial to assess the ability of methadone to lower the pain
caused by CIPN. It will help determine if it is feasible (ie. a good idea) to conduct a much
larger study to absolutely determine if methadone is able to treat painful CIPN. In this
pilot study, participants will receive methadone three times a day for 5 weeks. They will be
followed virtually or in-person weekly for 5 weeks where they will answer brief
questionnaires which will help determine the effect of their treatment on their pain and
their dose will increase until their pain is hopefully controlled.