Dexamethasone-sparing regimen is an effective and safe alternative in overall antiemetic protection

Abstract

Objective:We performed a meta-analyisis to evaluate the efficacy of maintenance dexamethasone against acute or delayed chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetic risk chemotherapy regimen.Methods:PubMed, Embase, and Cochrane Library were searched for eligible studies. Data comparing maintenance dexamethasone with single-dose dexamethasone during the acute, delayed, and overall phase of CINV were extracted. Overall risk ratio (RR) was used to estimate the efficacy and adverse effects.Results:Nine studies were included. In delayed phase, maintenance dexamethasone has similar efficacy to single-dose dexamethasone for no emetic episodes (RR, 1.06; 95% confidence interval [CI], 1.00–1.14), complete response (RR, 1.04; 95% CI, 0.98–1.11), complete control (RR, 1.07; 95% CI, 0.98–1.16), and total control (RR, 1.06; 95% CI, 0.91–1.23). In overall phase, maintenance dexamethasone has similar efficacy to single-dose dexamethasone for no emetic episodes (RR, 1.02; 95% CI, 0.94–1.11), complete response (RR, 1.02; 95% CI, 0.95 -1.09), complete control (RR, 1.03; 95% CI, 0.94–1.13), total control (RR, 1.05; 95% CI, 0.90–1.23), and no rescue medication (RR, 1.07; 95% CI, 0.97–1.19). Maintenance dexamethasone was only superior to single-dose dexamethasone for no rescue medication during delayed phase (RR, 1.10; 95% CI, 1.01–1.21, P = .034). The incidence of hiccup was observed higher in maintenance dexamethasone group (RR = 3.16, 95% CI, 1.12–8.92).Conclusion:The single-dose dexamethasone regimen offers high and similar overall control of symptoms as the maintenance dexamethasone regimen in this population. Multiple-day dexamethasone was suitable for patients who used rescue medication during the delayed phase.

Dexamethasone Sensitizes Cancer Stem Cells to Gemcitabine and 5-Fluorouracil by Increasing Reactive Oxygen Species Production through NRF2 Reduction

“…The prolonged administration of glucocorticoids can cause a number of side effects, such as insomnia, indigestion/discomfort in the upper abdomen, agitation, increased appetite, weight gain, acne, osteoporosis, and osteonecrosis [ 37 , 38 , 39 ]. In order to prevent these complications, recent studies recommend the administration of dexamethasone as an antiemetic in a shorter period of time in a regimen known as the dexamethasone-sparing regimen [ 40 , 41 ]. Our study suggests the need to consider the chemo-sensitizing effects of dexamethasone in determining the duration of dexamethasone therapy.…”

Molecular Engineering of Peptide–Drug Conjugates for Therapeutics

“…However, they initially used this strategy to modify dexamethasone to increase its anti-hepatic fibrosis effect in 2018 [71]. Dexamethasone is an FDA-approved drug used for treating many inflammatory conditions, such as bronchial asthma, endocrine inflammation, and gastrointestinal inflammation [72] Additionally, Dex was approved for the treatment of severe respiratory symptoms caused by COVID-19 in 2020 [73]. Scheme 6 summarized Dex and its derivatives that are mentioned in this part.…”

Hiccups in COVID-19: A rare complaint with many possible causes

“…[2] Nevertheless, we also considered the side effect of some drugs the patient inadvertently used as another cause for the hiccups. [2,5,6] There are scarce reports of hiccups related to amoxicillin-clavulanate or azithromycin in the literature. [5] However, dexamethasone is known to be related with hiccups.…”

“…[5] However, dexamethasone is known to be related with hiccups. [6] It should be noted that amoxicillin-clavulanate and azithromycin association is not formally indicated to treat COVID-19-associated pneumonia unless a bacterial co-infection is diagnosed. [1] Finally, dexamethasone should be considered for the treatment of people with COVID-19-associated pneumonia who need supplementary oxygen.…”