Aprepitant against pruritus in patients with solid tumours

Vincenzi, Bruno; Fratto, Maria Elisabetta; Santini, Daniele; Tonini, Giuseppe

doi:10.1007/s00520-010-0895-9

Cited by 49 publications

(29 citation statements)

References 5 publications

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“…of total patientsNo. of responding patientsComplete vs. partial responseItch ScaleResponse by ScaleAge, y/sexPrimary cause of itchDose of aprepitantLength of treatmentPatients with Malignancy Associated ItchDuval et al (2009) [20]33PartialVAS9 to 2N/ACTCL, SS80 mg/d7d7 to 28 to 3Vincenzi et al (2010) [21]22CompleteVAS8 to 044FNSCLC on erlotinibd1: 125 mg; d2, 3: 80 mg; then 125 mg, 80 mg alternating2mPartial9 to 174 MVincenzi et al (2010) [22]22CompleteVAS8 to 0N/A, MMetastatic soft tissue sarcomad1: 125 mg; d2, 3: 80 mg3dPartial9 to 1N/A, FMetastatic breast carcinomaBooken et al (2011) [15]54PartialVASMean 9.8 to 4.356FCTCL, SSd1: 125 mg; d2, 3: 80 mg; every 2 weeksMedian 15w (range 6–24)65FCTCL, SS65 MCTCL, SS51 MCTCL, MFMir et al (2011) [23]11PartialSubjectivePruritus regressed54, N/ANSCLC on erlotinib80 mg/d14dLadizinski et al (2012) [24]11PartialVAS10 to 166 MCTCL, MF80 mg/d; 3×/week4mSantini et al (2012) [14]2441CompleteVASMedian, 8 to 042-76 M/FRefractory itch, metastatic solid tumord1: 125 mg; d3, d5: 80 mg1w21PartialMedian, 8 to 145-70 M/F...…”

Section: Case Presentationmentioning

confidence: 99%

Aprepitant for refractory cutaneous T-cell lymphoma-associated pruritus: 4 cases and a review of the literature

et al. 2017

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BackgroundAprepitant is an FDA-approved medication for chemotherapy-induced nausea and vomiting. It blocks substance P binding to neurokinin-1; substance P has been implicated in itch pathways both as a local and global mediator.Case presentationsWe report a series of four patients, diagnosed with cutaneous T-cell lymphoma, who experienced full body pruritus recalcitrant to standard therapies. All patients experienced rapid symptom improvement (within days) following aprepitant treatment.ConclusionAprepitant has been shown in small studies to be efficacious for treating chronic and malignancy-associated pruritus. Prior studies have shown no change in clinical efficacy of chemotherapeutics with concurrent aprepitant administration. These cases further demonstrate that aprepitant can be considered as a therapeutic option in malignancy-associated pruritus and further support the need for larger clinical trials.

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Section: Case Presentationmentioning

confidence: 99%

Aprepitant for refractory cutaneous T-cell lymphoma-associated pruritus: 4 cases and a review of the literature

et al. 2017

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“…A recent study showed that aprepitant, a substance P receptor (NK1) antagonist, significantly inhibits scratching behavior in the NC/Nga mouse model of atopic dermatitis (101). More importantly, clinical studies demonstrated that aprepitant is effective for treating chronic pruritus, especially in patients with therapy-refractory pruritus (18, 128, 146). The inhibitory effect of this NK1 receptor antagonist could be caused by inhibition of substance P in the periphery or by blockage of NK1 + neurons in the dorsal spinal cord, which are involved in transmitting the itch sensation.…”

Section: Peripheral Itch Mediators and Related Receptorsmentioning

confidence: 99%

Itch Mechanisms and Circuits

Han

Dong²

2014

Annu. Rev. Biophys.

145

121

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The itch-scratch reflex serves as a protective mechanism in everyday life. However, chronic persistent itching can be devastating. Despite the clinical importance of the itch sensation, its mechanism remains elusive. In the past decade, substantial progress has been made to uncover the mystery of itching. Here, we review the molecules, cells, and circuits known to mediate the itch sensation, which, coupled with advances in understanding the pathophysiology of chronic itching conditions, will hopefully contribute to the development of new anti-itch therapies.

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“…Aprepitant was also found to be effective in treating malignancy-related pruritus [82, 83]. Consistent with these observations with aprepitant in humans, studies using NG/Nga mice, a murine model of atopic dermatitis, demonstrated that administration of NK1 receptor antagonist reduced scratching behaviour [84].…”

Section: Biological Mediators Of Itchmentioning

confidence: 88%

Basic mechanisms of itch

Potenzieri

Undem

2011

Clin Experimental Allergy

102

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Chronic itch represents a burdensome clinical problem that can originate from a variety of etiologies. Pruriceptive itch originates following the activation of peripheral sensory nerve endings following damage or exposure to inflammatory mediators and ascends to the brain through the spinal thalamic tract. Much insight has been gained into the understanding of the mechanisms underlying pruriceptive itch through studies using humans and experimental animals. More than one sensory nerve subtype is thought to subserve pruriceptive itch which includes both unmyelinated C-fibers and thinly myelinated Aδ nerve fibers. There are a myriad of mediators capable of stimulating these afferent nerves leading to itch, including biogenic amines, proteases, cytokines, and peptides. Some of these mediators can also evoke sensations of pain and the sensory processing underlying both sensations overlaps in complex ways. Studies have demonstrated that both peripheral and central sensitization to pruritogenic stimuli occur during chronic itch.

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Aprepitant against pruritus in patients with solid tumours

Cited by 49 publications

References 5 publications

Aprepitant for refractory cutaneous T-cell lymphoma-associated pruritus: 4 cases and a review of the literature

Aprepitant for refractory cutaneous T-cell lymphoma-associated pruritus: 4 cases and a review of the literature

Itch Mechanisms and Circuits

Basic mechanisms of itch

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