Department of Pharmacy, Kyushu University Hospital (KUH), Fukuoka, Japan.
Am J Health Syst Pharm. 2013 Feb 15;70(4):343-9. doi: 10.2146/ajhp120363.
Antiemetic effectiveness and safety of aprepitant in patients with hematologic malignancy receiving multiday chemotherapy were evaluated.
All data were retrospectively collected from the Kyushu University Hospital's electronic medical record system. Patients age 20 years or older with hematologic malignancies who received multiday chemotherapy were included in the study. All patients received 3 mg of granisetron i.v. 30 minutes before chemotherapy administration. Patients in the aprepitant group received 125 mg of aprepitant orally 60-90 minutes before administration of the first moderately to highly emetogenic chemotherapy (day 1). On day 2 or thereafter, an 80-mg oral dose of aprepitant was administered in the morning for up to five days. The primary endpoint was the percentage of patients who achieved complete response (CR).
A total of 42 patients were treated with aprepitant and granisetron as antiemetic prophylaxis between April and December 2010 (aprepitant group), and 40 patients were treated with only granisetron between March 1, 2009, and March 31, 2010, before the introduction of aprepitant. The percentage of patients who achieved CR in the aprepitant group was significantly higher than that in the control group (p = 0.01). Factors that were significantly associated with non-CR included the prophylactic use of aprepitant and chemotherapies containing ≥4 g/m(2)/day of cytarabine. The rates of adverse drug events (ADEs) did not significantly differ between groups.
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.
评估阿瑞匹坦在接受多日化疗的血液恶性肿瘤患者中的止吐效果和安全性。
所有数据均从九州大学医院的电子病历系统中回顾性收集。研究纳入年龄≥ 20 岁、接受多日化疗的血液恶性肿瘤患者。所有患者在化疗前 30 分钟接受 3 mg 格拉司琼静脉注射。阿瑞匹坦组患者在第 1 天接受中度至高度致吐性化疗（第 1 天）前 60-90 分钟口服 125mg 阿瑞匹坦。第 2 天或以后，每天早上给予 80mg 口服阿瑞匹坦，最多 5 天。主要终点是完全缓解（CR）患者的比例。
2010 年 4 月至 12 月期间，42 例患者接受阿瑞匹坦和格拉司琼作为止吐预防治疗（阿瑞匹坦组），2009 年 3 月 1 日至 2010 年 3 月 31 日在引入阿瑞匹坦之前，40 例患者仅接受格拉司琼治疗。阿瑞匹坦组患者的 CR 比例明显高于对照组（p=0.01）。与非 CR 相关的显著因素包括阿瑞匹坦预防用药和含有≥4g/m2/天阿糖胞苷的化疗方案。两组不良反应（ADE）发生率无显著差异。
在接受中度至高度致吐性多日化疗的血液恶性肿瘤患者中，阿瑞匹坦联合格拉司琼增加了止吐效果，而不影响 ADE。
