抗がん薬に伴う末梢神経障害に対するミロガバリンの有効性評価

抄録

Chemotherapy-induced peripheral neuropathy (CIPN) reduces patient quality of life, but there is little evidence of preexisting supportive care drugs. Mirogabalin is a novel drug with indications for peripheral neuropathic pain, and its mechanism of action involves strong and selective binding to the voltage-gated calcium channel α2δ subunit. We examined the effects of mirogabalin on CIPN. We followed up 21 patients with CIPN caused by taxanes or platinum-based anticancer drugs who started mirogabalin. A numerical rating scale (NRS) was used for the evaluation, and pharmacists evaluated the mirogabalin dose at its initiation by creatinine clearance in all patients, and no overdoses occurred. Mirogabalin significantly reduced NRS scores from a median of 6 to 2 (P < 0.001), and the median number of days of mirogabalin administration until determination of the best effect was 29.5 days. Furthermore, the median NRS significantly decreased by administration of mirogabalin in both the taxanes-based anticancer drug group and the platinum-based anticancer drug group. In the safety investigation, a somnolence grade of 1 or 2 was observed in 4 patients, an edema grade of 1 or 2 in 4 patients, and an edema grade of 3 was observed in 1 patient. There were no serious side effects that required hospitalization. Our study suggests mirogabalin has a palliative effect on CIPN and may be an important supportive care drug for chemotherapy. Simultaneously, it’s considered that pharmacists evaluate renal function and contribute to proper use, so that patients can expect the maximum drug efficacy after the introduction of mirogabalin.