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What Treatment Options Are Available for Myeloma Patients with Severe Neuropathy?

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Published on September 21, 2018

A Patient Power community member asks; what treatments are there for severe neuropathy as a side effect from multiple myeloma therapy? A panel of myeloma experts including Kristen Carter, an APRN from The UAMS Myeloma Institute, and Dr. Joshua Richter, from Mount Sinai School of Medicine, respond with current options for reducing the effects of neuropathy, how dose modification can help and why it’s critical to have an open dialogue with your healthcare team to effectively manage treatment side effects.

This is a Patient Empowerment Network program produced by Patient Power. We thank AbbVie, Inc., Celgene Corporation, and Takeda Oncology for their support.

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Transcript | What Treatment Options Are Available for Myeloma Patients With Severe Neuropathy?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jack Aiello:

We need to dose modify early. We need to start drugs like gabapentin or pregabalin (Lyrica).  I've used Cymbalta.  There's several different ways to treat peripheral neuropathy, but the main big thing is dose modification and dose interruption if you have a grade 2 or more neuropathy.  That's when you start to need to think about dose modification.  We do not want it to get to painful neuropathy and continue treatment.  

And then you look at the clinical research on the newer drugs like carfilzomib (Kyprolis) or ixazomib (Ninlaro) that does have less—less neuropathy associated with those drugs, so I've definitely used Kyprolis when someone had neuropathy with Velcade with not having further neuropathic symptoms with utilizing that drug. There's lots of other options out there that does not have the associated neuropathy symptoms.  

But the big takeaway would be let's not let it get to grade 3 before we're talking about neuropathy. So actually every visit, we talk about neuropathy at every visit.  I ask that question at every visit, so preemptively educating the patient that these are the symptoms that you may develop, and also letting the patient know, hey, let me know if you're having symptoms.  

But, again, this is really all about trying to prevent it and picking the right drugs and the right dosage.  There are some newer??we're starting to work on some clinical trials here for some novel approaches, but nothing as a cure?all just yet.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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