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3569 Characterising the clinical, functional and neurophysiological features of bortezomib induced peripheral neuropathy

bmjno · 2025-10-23 · canonical JSON source

4 visible annotations · policy: published · automated confidence ≥ 75.00%

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Background/Objectives Bortezomib-induced peripheral neuropathy (BIPN) is a common side effect of treatment for multiple myeloma. However, consensus on ideal outcome measures for BIPN in research and clinical practice remains elusive. This longitudinal study aimed to profile the development of BIPN using neurological and functional assessments.Methods Multiple myeloma patients undergoing bortezomib treatment were assessed at 3 timepoints (T0=baseline, T1=0–3 months, T2=12–24 months post-treatment). The Total Neuropathy Score (TNSc, 0–24) was used to assess neurological function, while a validated questionnaire (EORTC QLQ-CIPN20, 0–100) was used to assess patient reported symptoms. Sural and median sensory nerve action potentials (SNAPs) were also recorded in subsets of patients.Results A cohort of 17 patients (age=65.8(IQR=6.5) years, sex=65% male) were assessed. At T1, 82% patients reported tingling, numbness, or pain; 42% in both upper and lower limbs, and 58% in lower limbs only, consistent with a lower-limb sensory predominant neuropathy. Neurological deficits (TNSc T0=2(2), T1=3(3), p=0.041) and patient-reported symptoms (CIPN20 T0=3.51(7.02), T1=12.29(8.77), p=0.0015) were elevated by T1. By T2, neurological deficits persisted (TNSc T2=5(2.5), T0=2(2), p=0.0079), particularly reduced pin-prick sensation. However, patient-reported symptoms resolved to baseline levels (CIPN20 T2=5.26(5.27), T0=3.51(7.02), p=0.25).Sural amplitudes decreased numerically but not statistically (n=13; T0:9.5(11.5)µV, T1:9.0(15.0)µV, T2:6.65(14.0)µV, p=0.4388). However, median SNAP amplitudes were reduced at T1 (n=8; T0:26.76(19.77)µV, T1:23.94(17.21)µV; p=0.0391), but recovered by T2 (T2:27.87(9.67)µV, T0:26.76(19.77)µV, p=0.25).Conclusion Patient reported outcomes and neurophysiological assessments offer distinct snapshots of BIPN development, presentation and recovery, hence a multifaceted approach to assessment is essential.