Treatment strategy of oxaliplatin-induced peripheral neuropathy: a retrospective, nationwide study

PurposeChemotherapy-induced peripheral neuropathy (CIPN) is a common adverse events of cancer treatment; however, no drug is recommended for the prevention of CIPN. In Japan, several drugs such as Gosha-Jinki-Gan and duloxetine have been frequently administered for the treatment of CIPN. The aim of this study was to elucidate prescription patterns of drugs administered for the treatment of CIPN caused by oxaliplatin and the association between these drugs and the duration of oxaliplatin treatment.MethodsWe conducted a retrospective nationwide study using the JMDC administrative claims database (January 2005–June 2020). Patients newly treated with oxaliplatin were identified, and prescription patterns of CIPN medication including Gosha-Jinki-Gan, pregabalin, duloxetine, mecobalamin, and mirogabalin were investigated. The primary outcome was the duration of oxaliplatin treatment. Multivariable logistic regression analysis was performed to examine the association between CIPN medication and duration of oxaliplatin treatment.ResultsA total of 4,739 patients who newly received oxaliplatin were identified. Of these, 759 (16.0%) had received CIPN medication. Duloxetine was administered in 99 (2.1%) patients. Multivariable logistic regression analysis revealed that CIPN medication was significantly associated with the prolonged duration of oxaliplatin treatment (odds ratio: 2.35, [95% confidence interval: 1.99-2.77]).Conclusion Real-world data demonstrated that the administration rate of CIPN medication was higher in patients who underwent oxaliplatin treatment for over 6 months. Increasing administration preference of duloxetine and conducting prospective studies to verify the causal relationship between CIPN medication and prolonged duration of oxaliplatin treatment are needed.