Association between chemotherapy-induced neuropathy and gabapentin exposure among adults receiving chemotherapy: A National Inpatient Sample study (2017-2021).

Abstract

e24085 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of neurotoxic chemotherapy agents like taxanes and vincristine. Gabapentin is frequently prescribed in clinical practice for symptomatic management of CIPN, despite limited evidence supporting its role in CIPN prevention or severity reduction. Evaluating the association between gabapentin use and CIPN ,along with CIPN risk stratification may help inform clinical decision-making and guide appropriate use. Methods: A retrospective cross-sectional study using the International Classification of Diseases, 10th Revision (ICD-10) diagnosis codes from the National Inpatient Sample Database (2017-2021) was performed using Stata/BE. Multivariate logistic regression was used to estimate adjusted odds ratios (aOR) for categorical variables. Results were adjusted for other causes of neuropathy like alcohol use, obesity, diabetes, hypothyroidism, heart failure, end-stage renal disease, vitamin B12 deficiency, bone marrow transplantation, and immunotherapy exposure. Statistical significance was defined as a 95% confidence interval (95% CI) excluding the null value. Results: A total of 594,148 patients (mean age of 59 ± 20 years; 52.5% females) were included. Multivariate analysis showed a positive correlation between gabapentin exposure and CIPN (aOR 1.37; 95% CI 1.24–1.50), likely reflecting its use for neuropathic symptom management. Female sex (aOR 1.14; 95% CI 1.10–1.19) was positively associated and Hispanic race (aOR 0.83; 95% CI 0.75-0.91) was negatively associated with CIPN. Asian and Black races had a positive correlation while White race had a negative correlation with CIPN, but these findings were not significant. Vitamin B12 deficiency (aOR 2.17; 95% CI 1.44–3.30), bone marrow transplantation (aOR 1.34; 95% CI 1.21–1.50), and immunotherapy exposure (aOR 1.21; 95% CI 1.01–1.46) were significantly associated with CIPN. Diabetes and alcohol use did not show a positive correlation with CIPN possibly because these patients might already have been receiving gabapentin before chemotherapy initiation or because of alternative diagnostic coding. Conclusions: Gabapentin use at the time of chemotherapy initiation might have a protective or modifying effect in patients at a high risk of developing CIPN. However, further studies are needed to assess the temporal association between gabapentin use and specific chemotherapy agents, as well as to evaluate CIPN severity.