抗がん薬に伴う末梢神経障害に対するミロガバリンとデュロキセチンの有効性と安全性に関する探索的研究

抄録

Supportive therapies, such as mirogabalin (M) and duloxetine (D), are used to manage chemotherapy-induced peripheral neuropathy (CIPN) associated with taxane- and platinum-based anticancer agents. This study compared the efficacy and safety of M and D in patients with CIPN. Patients newly initiated on M (32 cases) or D (10 cases) for CIPN at the Ogaki Municipal Hospital between July 2023 and October 2024 were included. The numerical rating scale (NRS) score, NRS change rates, and adverse events were compared between the two groups 1 month after initiating supportive therapy.

The median NRS scores (range) 1 month after initiating supportive therapy were significantly reduced in both groups: M: 3 (0 – 6) and D: 3.5 (3 – 7), compared with the baseline scores: M: 4 (2 – 8) and D: 4 (3 – 10) (P = 0.004 and P = 0.021, respectively). The median minimum NRS scores were 3 (0 – 6) for M and 3 (2 – 4) for D. The median NRS change rates were −25.0％ (−100％ to 50％) and −29.2％ (−60％ to 0％) in the M and D groups, respectively (P = 0.309). Adverse events, such as somnolence, limb edema, and nausea, occurred in 46.9％ and 20％ of the M and D groups, respectively (P = 0.162). Somnolence was observed in 40.6％ and 10.0％ of the patients in the M and D groups, respectively.

These findings suggest that M and D have comparable efficacy and safety profiles for CIPN treatment. However, the higher incidence of somnolence (40.6％) in the M group warrants attention.