Concomitant Use of DPP-4 Inhibitors May Prevent the Development of Oxaliplatin-Induced Peripheral Neuropathy: A Retrospective Cohort Study.

Oxaliplatin-induced peripheral neuropathy (OIPN) causes numbness and pain in the limbs, often leading to interruption of chemotherapy and representing a significant clinical problem. Previous basic studies have suggested that the dipeptidyl peptidase-4 (DPP-4) inhibitor alogliptin may prevent OIPN. To evaluate whether concomitant use of DPP-4 inhibitors could prevent the development of OIPN in clinical practice, we retrospectively analyzed data from 1180 patients who initiated oxaliplatin treatment at Kyushu University Hospital between January 1, 2009 and December 31, 2019. The primary endpoint was the occurrence of OIPN of any grade. Kaplan-Meier analysis with cumulative doses demonstrated a significantly lower incidence of OIPN in the DPP-4 inhibitor group (p = 0.0422). After propensity score matching to adjust for patient backgrounds, the protective association remained significant (p = 0.0389). Furthermore, Cox proportional hazards analysis incorporating gender, age, regimen, and concomitant DPP-4 inhibitor use as covariates confirmed that DPP-4 inhibitor use was an independent protective factor for OIPN (HR = 0.690; 95% CI, 0.490-0.972; p = 0.034). These findings suggest that concomitant use of DPP-4 inhibitors may moderate the development of OIPN in patients receiving oxaliplatin.