Global estimates of prevalence of chronic painful neuropathy and moderate-to-severe neuropathy among patients with chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis of data from 29 countries between 2000 and 2024.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational prevalence studies
PubMed 39880412 · doi:10.1136/rapm-2024-106229
What was done
The authors conducted a systematic review and meta-analysis following PRISMA guidelines to estimate the pooled prevalence of chronic (≥3 months) moderate-to-severe chemotherapy-induced peripheral neuropathy (CIPN) or painful CIPN among patients diagnosed with CIPN. Across 76 studies from 29 countries published between 2000 and 2024, data were transformed using a double-arcsine approach and pooled with an inverse variance heterogeneity model. Subgroup analyses evaluated geographic region, sex, chemotherapy regimen, primary cancer, and funding; metaregressions evaluated study design, Human Development Index, and publication year.
What was found
Across 76 studies with 13,635 patients diagnosed with CIPN: - The pooled prevalence of chronic moderate-to-severe or painful CIPN was 47.76% (95% CI 37.50 to 58.08; 95% prediction interval 24.68 to 71.84) with high heterogeneity (I² = 97.45%). - By drug class, highest prevalence was observed in patients treated with taxanes (55.68%) and platinum-based agents (44.47%). - By cancer type, prevalence was highest in breast cancer (61.31%), multiple myeloma (53.55%), and lung cancer (50.85%). - Sensitivity analyses found a pooled prevalence of 40.78% (95% CI 29.08 to 52.74) in studies restricted to painful CIPN and 49.04% (95% CI 37.16 to 60.95) for moderate-to-severe CIPN.
Why it matters
This study provides the first global prevalence benchmark showing that nearly half of patients with CIPN suffer from persistent, moderate-to-severe, or painful neuropathy, identifying high-risk regimens and cancer populations that require targeted management.
Limits
The authors assigned a GRADE certainty rating of "very low." Heterogeneity was extreme across included studies (I² > 97%), and the 95% prediction interval ranged widely from 24.68% to 71.84%. Findings depend on heterogeneous diagnostic definitions and observational study designs.
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- supports Platinum-based chemotherapies have a higher incidence of nerve damage compared to other chemotherapy types.