ArticlePain reports2025
Comparative study evaluating the efficacy of duloxetine, gabapentin, and lacosamide on oxaliplatin-induced peripheral neuropathy.
Article in Pain reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Peripheral neuropathic pain limits oxaliplatin use and negatively impacts patients' quality of life. Objectives: This study was conducted to assess the impact of gabapentin and lacosamide on oxaliplatin-induced peripheral neuropathy compared with duloxetine. Methods: In this randomized, double-blind study, 93 patients receiving oxaliplatin-based chemotherapy (FOLFOX-4 regimen: folinic acid, fluorouracil, and oxaliplatin) were assigned to 1 of 3 groups. Group 1 received duloxetine 30 mg/d, group 2 received gabapentin 300 mg/d, and group 3 received lacosamide 50 mg/d throughout 12 chemotherapy cycles. Neuropathy was assessed using the McGill Pain Questionnaire, 12-item neurotoxicity questionnaire (NTX-12), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and grading according to the Common Terminology Criteria for Adverse Events. Serum neuroinflammatory biomarkers, including nuclear factor kappa B, neurotensin, neurofilament light chain, and heme oxygenase-1, were also evaluated, along with adverse drug effects. Results: At cycles 10 and 12, the incidence of grade 2 to 3 neuropathy was significantly lower with duloxetine and lacosamide compared with gabapentin (45.2% and 32.2% vs 70.9%, Conclusions: Lacosamide demonstrated neuroprotective efficacy comparable with duloxetine and may represent a promising therapeutic option for oxaliplatin-induced peripheral neuropathy.
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