Aprepitant: Evidence of its effectiveness in patients with refractory pruritus continues

Torres, Tiago; Fernandes, Isabel; Selores, Manuela; Alves, Rosário; Lima, Margarida

doi:10.1016/j.jaad.2011.01.016

Cited by 55 publications

(35 citation statements)

References 4 publications

(4 reference statements)

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“…Aprepitant shows an antiemetic effect in various chemotherapies [21, 22], but there is little information regarding aprepitant’s antiemetic effect in patients treated with an R-CHOP or R-CHOP-like regimen. In the present study, there were no significant differences in the rates of nausea and vomiting between the early-onset VIPN (-) and early-onset VIPN (+) groups despite the high concomitant use of aprepitant in the early-onset VIPN (+) group (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Early-Onset Peripheral Neuropathy Caused by Vincristine in Patients With a First Administration of R-CHOP or R-CHOP-Like Chemotherapy

et al. 2014

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BackgroundPeripheral neuropathy is a well-known side effect of vincristine (VCR), a microtubule inhibitor used for R-CHOP or R-CHOP-like (namely R-CVP and R-THP-COP) regimens. Previous studies have shown that both the total dose of VCR and the number of treatment cycles are related to the incidence of VCR-induced peripheral neuropathy (VIPN). However, VIPN will also occur during the first treatment cycle regardless of the total dose of VCR or number of treatment cycles (early-onset VIPN). There is little information about early-onset VIPN, and it is difficult to predict. The present study’s goal was to identify risk factors for early-onset VIPN.MethodsWe analyzed the case records of patients who had their first administration of an R-CHOP or R-CHOP-like regimen between April 2008 and August 2013 at Tokushima University Hospital in Tokushima, Japan. To identify the risk factors for early-onset VIPN, we performed univariate and multivariate logistic regression analyses.ResultsForty-one patients underwent an R-CHOP or R-CHOP-like regimen for the first time at Tokushima University Hospital between April 2008 and August 2013, and 14 patients had grade 1 or higher early-onset VIPN. A univariate analysis revealed that age, the dose of VCR and the concomitant use of aprepitant appeared to be the risk factors of early-onset VIPN. In our calculation using receiver-operator characteristics curves, the cut-off value for patient age was 65 years and that of the dose of VCR was 1.9 mg. A multivariate analysis revealed that VCR dose ≥ 1.9 mg and the concomitant use of the antiemetic aprepitant were independent risk factors for early-onset VIPN.ConclusionsOur present study showed that the patients who had VCR dose ≥ 1.9 mg and the concomitant use of aprepitant had the risk for early-onset VIPN. This suggests that it is important to use aprepitant in light of the risk of early-onset VIPN and the benefit of aprepitant’s antiemetic effect in R-CHOP and R-CHOP-like regimens.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Early-Onset Peripheral Neuropathy Caused by Vincristine in Patients With a First Administration of R-CHOP or R-CHOP-Like Chemotherapy

et al. 2014

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“…Of note, increased neurokinin-1 (NK1) expression on keratinocytes of patients with chronic pruritus has been described. A case report determined that aprepitant was useful in the treatment of chronic pruritus secondary to Sézary syndrome and described no major side effects with its use [156].…”

Section: Systemic Treatmentsmentioning

confidence: 99%

Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management

2015

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Chronic itch in the elderly is a common problem, with a significant impact on quality of life and sleep in elderly patients. Chronic itch may be attributable to several causes, including dry skin, immunosenescence and neural degeneration. Itch may also be caused by skin diseases, such as seborrhoeic dermatitis and stasis dermatitis; systemic conditions, such as end-stage renal disease and diabetes; and psychogenic conditions, such as depression and anxiety. The use of polypharmacy may also cause itch, with or without a rash. Specifically, thiazides and calcium channel blockers have been known to cause itch in elderly patients. Management should be tailored according to the underlying dermatological or systemic aetiology of itch. Topical treatment is the mainstay of therapy, providing special emphasis on skin hydration and barrier repair. In addition, topical and oral medications that target the nervous system and reduce neuronal hypersensitization, such as gabapentin and selective antidepressants, have a role in treating patients with severe chronic itch. Furthermore, management must account for changes in metabolism and pharmacokinetics of drugs in the aging population in order to prevent the occurrence of adverse effects.

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“…and Duval et al . reported two and three patients, respectively, with SS in whom aprepitant 80 mg daily successfully controlled pruritus . Ladizinski et al .…”

Section: Resultsmentioning

confidence: 99%

Inflammatory cytokines and peripheral mediators in the pathophysiology of pruritus in cutaneous T‐cell lymphoma

Lewis

Huang

Duvic

2018

Acad Dermatol Venereol

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Cutaneous T-cell lymphoma (CTCL) includes a diverse group of neoplasms, including mycosis fungoides and Sézary syndrome. One of the earliest and most common symptoms of CTCL is pruritus, which affects up to 88% of patients. The severity of pruritus can range from mild to very debilitating, producing tremendous discomfort and a significant decrease in quality of life. Patients with advanced disease, in particular, may experience a more chronic, intractable pruritus. However, the underlying mechanism of pruritus in CTCL remains unknown. Conventional antipruritic agents, such as antihistamines, gamma-aminobutyric acid analogs and antidepressants, are only partially effective in relieving symptoms, suggesting a more complex, unique pathophysiology. In this review, we summarize the current research on cytokines and peripheral mediators implicated in pruritus in CTCL.

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Aprepitant: Evidence of its effectiveness in patients with refractory pruritus continues

Cited by 55 publications

References 4 publications

Risk Factors for Early-Onset Peripheral Neuropathy Caused by Vincristine in Patients With a First Administration of R-CHOP or R-CHOP-Like Chemotherapy

Risk Factors for Early-Onset Peripheral Neuropathy Caused by Vincristine in Patients With a First Administration of R-CHOP or R-CHOP-Like Chemotherapy

Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management

Inflammatory cytokines and peripheral mediators in the pathophysiology of pruritus in cutaneous T‐cell lymphoma

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