Avaliação das concentrações séricas de magnésio de pacientes submetidos a quimioterapia com derivados de platina em associação com inibidores de bombas de prótons e sua correlação com as neuropatias: um ensaio clínico, duplo cego, controlado por placebo

Abstract

Platinum-based drugs are regularly prescribed in the treatment of cancer and, although they are effective, their use is limited by serious adverse reactions. Another group of drugs used in cancer patients are proton pump inhibitors (PPIs) in order to prevent and treat gastric reactions during cancer treatment. However, both drugs can cause hypomagnesemia, by different mechanisms. The work aims to evaluate serum magnesium concentrations in patients undergoing chemotherapy with platinum derivatives in association with proton pump inhibitors and their correlation with neuropathies. This is a randomized, double-blind clinical study. 164 patients undergoing chemotherapy with regimens containing cisplatin or carboplatin were included, checking the inclusion and exclusion criteria. The volunteers were randomized into Lots 1 and 2 at a ratio of 1: 1, consecutively, in the groups using cisplatin and carboplatin, batches were revealed only after the end of the study. According to the data, there was a higher frequency of patients with head and neck and lung cancer, for both groups. Mean age was 61.0 ± 12.5 for the placebo group and 57.7 ± 14.3 for the PPI group, where the most frequent protocols were carboplatin plus paclitaxel, followed by cisplatin (monotherapy). Regarding hypomagnesemia, a tendency to decrease serum magnesium levels was highlighted in both groups (β = - 0.035; p <0.001), especially in those patients with preserved renal function (β = -0.414; p <0.001). There was a more pronounced decrease in serum magnesiumIn in the omeprazole group compared to placebo (β = -0.121; p = 0.031). There was no difference in the occurrence of clinical manifestations of the gastrointestinal tract and neuropathy, however, the use of omeprazole caused less nausea and vomiting (p = 0.005). The results of the study showed a trend of hypomagnesemia in both groups, with a greater hypomagnesemia in the intervention group, but without significant difference in the evaluated reactions. The platinum group associated with omeprazole suggests a possible benefit of omeprazole in preventing nausea and vomiting.