Abstract：
Several widely used medications, with a relevant efficacy profile, are toxic to the peripheral nervous system and an even larger number of agents are suspected to be neurotoxic. There are concerns about the use of these drugs in patients with Charcot-Marie-Tooth disease (CMT), a hereditary motor and sensory neuropathy. This review provides evidence-based updated recommendations on this clinically relevant topic.
A systematic review of the available studies/reports written in English was performed from July to September 2022 including in the search string all reported putative neurotoxic drugs.
The results of our systematic review provide evidence-based support for the statement that use of vincristine, and possibly paclitaxel, can occasionally induce an atypical, and more severe, course of drug-related peripheral neurotoxicity in CMT patients. It is therefore reasonable to recommend caution in the use of these compounds in CMT patients. However, no convincing evidence for a similar recommendation could be found for all other drugs.
It is important that patients with CMT are not denied effective treatments that may prolong life expectancy for cancer or improve their health status if affected by non-oncological diseases. Accurate monitoring of peripheral nerve function in CMT patients treated with any neurotoxic agent remains mandatory to detect the earliest signs of neuropathy worsening and atypical clinical courses. Neurologists monitoring CMT patients as part of their normal care package or for natural history studies should keep detailed records of exposures to neurotoxic medications and support reporting of accelerated neuropathy progression if observed.
A systematic review of the available studies/reports written in English was performed from July to September 2022 including in the search string all reported putative neurotoxic drugs.
The results of our systematic review provide evidence-based support for the statement that use of vincristine, and possibly paclitaxel, can occasionally induce an atypical, and more severe, course of drug-related peripheral neurotoxicity in CMT patients. It is therefore reasonable to recommend caution in the use of these compounds in CMT patients. However, no convincing evidence for a similar recommendation could be found for all other drugs.
It is important that patients with CMT are not denied effective treatments that may prolong life expectancy for cancer or improve their health status if affected by non-oncological diseases. Accurate monitoring of peripheral nerve function in CMT patients treated with any neurotoxic agent remains mandatory to detect the earliest signs of neuropathy worsening and atypical clinical courses. Neurologists monitoring CMT patients as part of their normal care package or for natural history studies should keep detailed records of exposures to neurotoxic medications and support reporting of accelerated neuropathy progression if observed.
摘要：
目的：几种广泛使用的药物，有相关的功效简介，对周围神经系统有毒，甚至有更多的药物被怀疑是神经毒性的。人们担心在Charcot-Marie-Tooth病（CMT）患者中使用这些药物，遗传性运动和感觉神经病.这篇综述提供了关于这一临床相关主题的循证更新建议。
方法：从2022年7月至9月对可用的英文研究/报告进行了系统评价，包括搜索字符串中的所有报告的假定的神经毒性药物。
结果：我们的系统评价结果为使用长春新碱的陈述提供了基于证据的支持，可能还有紫杉醇,偶尔会诱发非典型的，更严重的是，CMT患者与药物相关的周围神经毒性的病程。因此，建议在CMT患者中谨慎使用这些化合物是合理的。然而,没有令人信服的证据证明所有其他药物都有类似的建议.
结论：重要的是，不要拒绝CMT患者接受有效的治疗，如果受非肿瘤性疾病影响，这些治疗可能会延长癌症的预期寿命或改善他们的健康状况。在接受任何神经毒性药物治疗的CMT患者中，对周围神经功能的准确监测仍然是强制性的，以检测神经病变恶化和非典型临床过程的最早迹象。作为正常护理包的一部分或用于自然史研究的监测CMT患者的神经学家应保留对神经毒性药物暴露的详细记录，并支持观察到加速神经病变进展的报告。本文受版权保护。保留所有权利。
方法：从2022年7月至9月对可用的英文研究/报告进行了系统评价，包括搜索字符串中的所有报告的假定的神经毒性药物。
结果：我们的系统评价结果为使用长春新碱的陈述提供了基于证据的支持，可能还有紫杉醇,偶尔会诱发非典型的，更严重的是，CMT患者与药物相关的周围神经毒性的病程。因此，建议在CMT患者中谨慎使用这些化合物是合理的。然而,没有令人信服的证据证明所有其他药物都有类似的建议.
结论：重要的是，不要拒绝CMT患者接受有效的治疗，如果受非肿瘤性疾病影响，这些治疗可能会延长癌症的预期寿命或改善他们的健康状况。在接受任何神经毒性药物治疗的CMT患者中，对周围神经功能的准确监测仍然是强制性的，以检测神经病变恶化和非典型临床过程的最早迹象。作为正常护理包的一部分或用于自然史研究的监测CMT患者的神经学家应保留对神经毒性药物暴露的详细记录，并支持观察到加速神经病变进展的报告。本文受版权保护。保留所有权利。
