Types of Peripheral Neuropathy

These are the different types of peripheral neuropathy WinSanTor is currently focusing on:

Diabetic Peripheral Neuropathy (DPN)

Evidence of neurodegenerative disease has been found in the peripheral nerves of diabetics. Currently more than 50% of diabetic patients develop some form of peripheral nerve disease, which can lead to loss of sensation, tingling, pain, limb amputation, and death.

No FDA-approved treatment exists for diabetic neuropathy, a condition that afflicts over half of the 29 million Americans (over 415 million worldwide) who suffer from diabetes. Although drugs exist to relieve the pain, the goal for those that aim to treat this major unmet clinical need is a therapy that can prevent the onset of nerve damage, and reverse (regrow) damaged nerves and loss of function and quality of life.

There is no disease-modifying or curative treatment approved for diabetic neuropathy. Current approaches at best mitigate the pain or attempt to control the underlying diabetes.

Chemo-induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy (CIPN) is a medical condition affecting over two-thirds of cancer patients undergoing therapy. Many of the first line chemotherapeutic agents cause peripheral neuropathy (shown in Table 1), and many patients cannot receive efficacious doses because of the neuropathy. Although CIPN decreases with time, up to 30% of patients continue to suffer after 6 months. Overall, the prevalence of CIPN is on the rise and increases as the life expectancy of cancer patients do. The symptoms of CIPN are similar to DPN with descriptions of paresthesias, dysesthesias, and/or pain. As with other forms of peripheral neuropathy, there are no treatments available outside pain drugs that reduce or mask the symptoms. Some alternative treatments shown to provide some relief are acupuncture and manual lymph drainage.

Table 1

Drug NameTypes of cancer treatedMechanism of actionNeuropathyIncidence
Platinum-based drugsLung, ovarian, bladder, germ cells, testicular, colorectal cancerCancer cell DNA-cross-linkingVery high70 – 100%
TaxanesBreast, ovarian, lung, prostrate, pancreatic cancerCancer cell microtubule formation impairmentHigh11 – 87%
Thalidomide and its analogsMultiple myelomaAnti-angiogenesis immunomodulationHigh20 – 60%
IxabepiloneBreast cancerTubulin malformationHigh60 – 65%
BortezomibMultiple myelomaProteosome inhibitionModerate20 – 30%
Vinca alkaloidsLung, brain, bladder, testicular cancerCancer cell microtubule formation impairmentModerateUp to 20%

HIV-induced Peripheral Neuropathy

According to the CDC, around 1.1 million Americans above the age of 12 are currently living with the HIV infection. Worldwide, UNAIDS reports approximately 36.7 million people living with HIV and AIDS. Anywhere between 30-60% of those infected will develop a form of neuropathy including sensory, motor and autonomic indications. The peripheral neuropathy can stem from both the infection and the drugs used to treat the infection. These d-drugs (dideoxynucleoside reverse transcriptase inhibitors) are referred to as “neurotoxic” and have been proven to cause peripheral neuropathy in multiple scientific settings.

HIV-induced peripheral neuropathy, aka “anti-retroviral toxic neuropathy,” makes up about 2% of those inflicted with peripheral neuropathy in general.