Antiemetic effectiveness and safety of aprepitant in patients with hematologic malignancy receiving multiday chemotherapy

Uchida, Mayako; Ikesue, Hiroaki; Katô, Kôji; Ichinose, Kimiko; Hiraiwa, Hiromi; Sakurai, Asako; Takenaka, Katsuto; Iwasaki, Hiromi; Miyamoto, Toshihiro; Teshima, Takanori; Egashira, Nobuaki; Akashi, Koichi; Oishi, Ryozo

doi:10.2146/ajhp120363

Cited by 13 publications

(14 citation statements)

References 33 publications

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“…Recently, we reported that the addition of aprepitant to granisetron improved antiemetic control without influencing AdEs in patients with hematologic malignancies receiving multiday conventional chemotherapy. 21) In the present study, the frequencies of AdEs in the control and aprepitant groups were similar. Based on these results, aprepitant can be safely Table 1.…”

Section: -18)supporting

confidence: 64%

“…At our institution, pharmacists and physicians had discussed the antiemetic treatment for the patients with hematologic malignancies, and introduced aprepitant to conventional chemotherapies 21) as well as preparative regimens for HSCT since April 2010. In this study, we retrospectively evaluated the antiemetic effect and safety of aprepitant in combination with 5-HT 3 receptor antagonist in such patients undergoing autologous peripheral blood stem cell transplantation (auto-PBSCT).…”

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confidence: 99%

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Effectiveness and Safety of Antiemetic Aprepitant in Japanese Patients Receiving High-Dose Chemotherapy Prior to Autologous Hematopoietic Stem Cell Transplantation

Uchida

Ikesue

Miyamoto

et al. 2013

Biological & Pharmaceutical Bulletin

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For patients receiving high-dose chemotherapy, a 5-hydroxytryptamine 3 receptor antagonist combined with dexamethasone is a standard antiemetic therapy. Despite this prophylactic anti-emetic treatment, many patients still suffer from uncontrollable emesis. In this study, we retrospectively evaluated the antiemetic effectiveness and safety of aprepitant (a neurokinin-1 receptor antagonist) in addition to 5-HT 3 antagonist in Japanese patients with hematologic malignancy receiving high-dose chemotherapy prior to autologous peripheral blood stem cell transplantation (auto-PBSCT). Twenty-six patients received aprepitant and granisetron (the aprepitant group), whereas, 22 patients received granisetron alone (the control group). All patients received 3 mg of granisetron intravenously 30 min before chemotherapy administration. Patients in the aprepitant group additionally received 125 mg of aprepitant 60-90 min before administration of the first moderately to highly emetogenic chemotherapy. On the next day or thereafter, 80 mg of aprepitant was administered in the morning until the last administration of moderately to highly emetogenic anticancer drugs. The percentage of patients who achieved complete response (CR), defined as no emesis with only grade 1-2 nausea, in the aprepitant group was significantly higher than that in the control group (42% vs. 5%, p=0.003). Logistic regression analysis showed that non-prophylactic use of aprepitant was significantly associated with non-CR. The frequencies of adverse drug events (ADEs) were not significantly different between two groups. In conclusion, the results of this study suggest that the addition of aprepitant to granisetron can improve the antiemetic effect without increasing ADEs in patients receiving high-dose chemotherapy prior to auto-PBSCT.

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Section: -18)supporting

confidence: 64%

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confidence: 99%

Effectiveness and Safety of Antiemetic Aprepitant in Japanese Patients Receiving High-Dose Chemotherapy Prior to Autologous Hematopoietic Stem Cell Transplantation

Uchida

Ikesue

Miyamoto

et al. 2013

Biological & Pharmaceutical Bulletin

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“…Although the agent cytarabine when administered at a dose of greater than 1 g/m 2 is currently classified as having a moderate emetogenic potential, recent data indicate that regimens containing a cytarabine dose of ≥4 g/m 2 per day should be considered as highly emetogenic [14,[22][23][24]. In a recent trial, two extended schedules of palonosetron from day 1 to day 5 or on days 1, 3 and 5, were randomly compared with daily ondansetron in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome treated with regimens containing high-dose cytarabine (12 g/m 2 for 3 days or 30 mg/m 2 for 5 days) [14].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an Every-Other-Day Palonosetron Schedule to Control Emesis in Multiple-Day High-Dose Chemotherapy

et al. 2014

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“…Several studies in chemotherapy patients, both large and small, showed that addition of aprepitant to standard antiemetic regimens led to significant improvements in nausea and vomiting [74,75]. It has subsequently been adopted by gastroenterologists for off-label use in patients with gastroparesis.…”

Section: Neurokinin-1 Receptor Antagonistsmentioning

confidence: 99%

Current advances in treatment of gastroparesis

Malamood

Parkman

Schey

2015

Expert Opinion on Pharmacotherapy

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The numerous motor functions and neural inputs that control gastric motility are complex and not fully understood. Our lack of understanding of its pathophysiology has led to treatment options which are empirical, palliative and often ineffective. Newly intensified interest in the cellular pathophysiology behind gastroparesis provides promise for a new era of treatments. Identification of common cellular changes in gastroparesis has provided targets for treatment that may allow us to one day better treat the symptoms of gastroparesis related to its underlying pathophysiology. This is the future of gastroparesis therapy.

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Antiemetic effectiveness and safety of aprepitant in patients with hematologic malignancy receiving multiday chemotherapy

Abstract: The addition of aprepitant to granisetron increased the antiemetic effect without influencing ADEs in patients treated with moderately to highly emetogenic multiday chemotherapy for hematologic malignancies.

Cited by 13 publications

References 33 publications

Effectiveness and Safety of Antiemetic Aprepitant in Japanese Patients Receiving High-Dose Chemotherapy Prior to Autologous Hematopoietic Stem Cell Transplantation

Effectiveness and Safety of Antiemetic Aprepitant in Japanese Patients Receiving High-Dose Chemotherapy Prior to Autologous Hematopoietic Stem Cell Transplantation

Evaluation of an Every-Other-Day Palonosetron Schedule to Control Emesis in Multiple-Day High-Dose Chemotherapy

Current advances in treatment of gastroparesis

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