Role of pregabalin in treatment of oxaliplatin-induced sensory neuropathy.
BACKGROUND
Oxaliplatin use in gastrointestinal malignancies is limited by neurotoxicity. This study aimed to assess the efficacy of pregabalin (LYRICA(R)) in the treatment of oxaliplatin-induced neurotoxicity.


METHODS
A total of 23 gastrointestinal cancer patients with grade 2 and 3 oxaliplatin-induced sensory neuropathy were treated with pregabalin up to a target dose of 150mg orally (PO) three times a day (tid) based on benefit and tolerance. Neurological symptoms were serially evaluated.


RESULTS
The target dose of 150 mg tid provided the best benefit, but patients benefited even at lower doses. Onset of benefit was observed in 2-6 weeks. In the majority of patients (48%), neuropathy improved by 1 to 2 grades.


CONCLUSIONS
Pregabalin significantly reduced the severity of oxaliplatin-induced sensory neuropathy. Being more potent than gabapentin, pregabalin achieved efficacy at lower doses and should lead to fewer dose-related side effects, although this remains to be established in a head-to-head trial.
Saif
Muhammad Wasif
MW
Yale University School of Medicine, Section of Medical Oncology, 333 Cedar Street; FMP 116, New Haven, CT 06520, USA. wasif.saif@yale.edu
Syrigos
Kostas
K
Kaley
Kristin
K
Isufi
Iris
I
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004305:Dose-Response Relationship, Drug; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000188:drug therapy* / Q000209:etiology*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D015251:Epirubicin; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000069287:Capecitabine; D005472:Fluorouracil; D000093542:Gemcitabine