质子泵抑制剂联合使用预防奥沙利铂诱导的周围神经病变：临床回顾性队列研究。

IF 2.9 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pharmacotherapy Pub Date : 2025-05-10 DOI:10.1002/phar.70028

Keisuke Mine, Takehiro Kawashiri, Kohei Mori, Yusuke Mori, Haruna Ishida, Hibiki Kudamatsu, Shunsuke Fujita, Mayako Uchida, Takaaki Yamada, Nobuaki Egashira, Ichiro Ieiri, Satoru Koyanagi, Shigehiro Ohdo, Takao Shimazoe, Daisuke Kobayashi

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引用次数: 0

摘要

背景：奥沙利铂诱导的周围神经病变（OIPN）是一个主要的临床挑战，因为它会导致化疗停止。奥美拉唑是一种质子泵抑制剂（PPI），在大鼠模型中已被证明可以预防OIPN。因此，我们的目的是测试是否同时使用PPI可以减少OIPN导致的奥沙利铂停药。方法：这项回顾性研究使用了1015名开始接受奥沙利铂治疗的患者的数据，并评估了两个队列（PPI与非PPI）。主要结局指标为OIPN引起的奥沙利铂停药。对累积剂量生成Kaplan-Meier曲线，并使用对数秩检验和Cox比例风险分析进行评估。结果：log-rank检验显示，PPI组因OIPN而停用奥沙利铂的患者数量明显减少（p = 0.0264）。Cox比例风险分析纳入并分析了先前报道的可能影响神经病变的因素（性别、年龄、使用PPIs、钙通道拮抗剂、阿片类药物和辅助镇痛药，以及CAPOX[卡培他滨+奥沙利铂]方案）。分析表明，同时使用PPIs是减少奥沙利铂停药的一个因素（校正风险比[HR] = 0.568, 95%可信区间[CI]， 0.344-0.937, p = 0.0269）。由于两组之间的某些患者人口统计数据存在显著差异，因此进行倾向评分匹配以对齐患者人口统计数据，然后重新分析。倾向评分匹配后，与前文相同的分析显示，PPI组因OIPN导致奥沙利铂停药的发生率显著降低（p = 0.0081）；cox比例风险分析显示，使用PPI是显著减少OIPN导致奥沙利铂停药的因素（调整后HR = 0.478, 95% CI, 0.273-0.836, p = 0.0096）。结论：这些结果表明，在接受奥沙利铂治疗的患者中，同时使用PPI可能会减少由于OIPN导致的奥沙利铂停药。

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Proton pump inhibitor concomitant use to prevent oxaliplatin-induced peripheral neuropathy: Clinical retrospective cohort study.

Background: Oxaliplatin-induced peripheral neuropathy (OIPN) is a major clinical challenge because it leads to discontinuation of chemotherapy. Omeprazole, a proton pump inhibitor (PPI), has been shown to prevent OIPN in a rat model. Therefore, we aimed to test whether the concomitant use of a PPI reduces oxaliplatin discontinuation due to OIPN.

Methods: This retrospective study used data from 1015 patients who started treatment with oxaliplatin and evaluated two cohorts (PPI vs. non-PPI). The primary outcome measure was oxaliplatin discontinuation due to OIPN. A Kaplan-Meier curve was generated for cumulative doses and evaluated using the log-rank test and Cox proportional hazards analysis.

Results: The log-rank test showed that the number of patients who discontinued oxaliplatin due to OIPN was significantly lower in the PPI group (p = 0.0264). Cox proportional hazards analysis incorporated and analyzed factors previously reported as potentially affecting neuropathy (sex, age, use of PPIs, calcium channel antagonists, opioids and adjuvant analgesics, and the CAPOX [capecitabine + oxaliplatin] regimen). The analysis suggested that the concomitant use of PPIs was a factor in reducing oxaliplatin discontinuation (adjusted hazard ratio [HR] = 0.568, 95% confidence interval [CI], 0.344-0.937, p = 0.0269). Since there were significant differences in some patient demographics between the two groups, propensity score matching was performed to align the patient demographics and then reanalyzed. After propensity score matching, the same analysis as above showed that oxaliplatin discontinuation due to OIPN was significantly less common in the PPI group (p = 0.0081); cox proportional hazards analysis showed that PPI use was a factor that significantly reduced oxaliplatin discontinuation due to OIPN (adjusted HR = 0.478, 95% CI, 0.273-0.836, p = 0.0096).

Conclusions: These results suggest that concomitant PPI use may reduce oxaliplatin discontinuation due to OIPN in patients receiving oxaliplatin.

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来源期刊

Pharmacotherapy 医学-药学

CiteScore

7.80

自引率

2.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.