Yang Chuanli, Xu Pengyang, Wu Teng, Fan Yunhe, Li Qingqing, Zhang Jijun, Shen Xiaobing, Dong Xiushan
Department of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Key Laboratory of Environmental Medical Engineering and Education Ministry, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Front Pharmacol. 2024 Jul 31;15:1413709. doi: 10.3389/fphar.2024.1413709. eCollection 2024.
Aprepitant, fosaprepitant, and netupitant are three common neurokinin-1 receptor antagonists (NK-1RAs) used to prevent chemotherapy-induced nausea and vomiting, following highly or moderately emetogenic chemotherapy. Understanding their different adverse event (AE) profiles may help clinicians make appropriate treatment decisions.
All data collected from the FDA Adverse Event Reporting System (FAERS) database from the first quarter of 2004 to the fourth quarter of 2023 underwent disproportionality analysis to detect, evaluate, and compare AE signals of the three NK-1RAs.
A total of 3,904, 1,123, and 243 AE reports related to aprepitant, fosaprepitant, and netupitant, respectively, were extracted from the FAERS database. Of these, more than 50% of respondents were female, and most of them were aged 45-65 years. General disorders and administration-site conditions, and gastrointestinal disorders were the most frequent signals in the system organ class of the three NK-1RA drugs. In addition, aprepitant was strongly associated with joint deposit (ROR = 26.27) and fosaprepitant was closely related to seizure-like phenomena (ROR = 26.90); two preferred terms (PTs) were not mentioned in the manual. Statistically, netupitant was likely to induce death (N = 63, ROR = 8.78, 95% CI: 6.75-11.42). Additionally, neutropenic colitis, colitis, and stomatitis were unique to netupitant. Furthermore, the AE profiles of the three NK-1RA drugs were different by gender.
The AE profiles for aprepitant, fosaprepitant, and netupitant were different. In addition to paying attention to common AEs, clinicians need to pay attention to new emerging AEs, such as joint deposit, seizure-like phenomena, neutropenic colitis, colitis, and stomatitis, regarding the three NK-1RA drugs. Furthermore, the AE compositions of the three NK-1RA drugs were different in different genders, and clinicians should take these factors into account when selecting NK-1RAs for CINV treatment.
阿瑞匹坦、福沙匹坦和奈妥匹坦是三种常见的神经激肽-1受体拮抗剂（NK-1RAs），用于在接受高度或中度致吐性化疗后预防化疗引起的恶心和呕吐。了解它们不同的不良事件（AE）特征可能有助于临床医生做出合适的治疗决策。
收集2004年第一季度至2023年第四季度美国食品药品监督管理局不良事件报告系统（FAERS）数据库中的所有数据，进行不成比例分析，以检测、评估和比较三种NK-1RAs的AE信号。
分别从FAERS数据库中提取了3904份、1123份和243份与阿瑞匹坦、福沙匹坦和奈妥匹坦相关的AE报告。其中，超过50%的受访者为女性，且大多数年龄在45至65岁之间。在这三种NK-1RA药物的系统器官类别中，全身性疾病和给药部位状况以及胃肠道疾病是最常见的信号。此外，阿瑞匹坦与关节沉积物密切相关（报告比值比[ROR]=26.27），福沙匹坦与癫痫样现象密切相关（ROR=26.90）；手册中未提及这两个首选术语。从统计学角度看，奈妥匹坦可能导致死亡（N=63，ROR=8.78，95%置信区间：6.75-11.42）。此外，中性粒细胞减少性结肠炎、结肠炎和口腔炎是奈妥匹坦特有的。此外，这三种NK-RA药物的AE特征因性别而异。
阿瑞匹坦、福沙匹坦和奈妥匹坦的AE特征各不相同。除了关注常见的AE外，临床医生还需要关注这三种NK-1RA药物新出现的AE，如关节沉积物、癫痫样现象、中性粒细胞减少性结肠炎、结肠炎和口腔炎。此外，这三种NK-1RA药物的AE构成在不同性别中有所不同，临床医生在选择NK-1RAs进行化疗引起的恶心和呕吐（CINV）治疗时应考虑这些因素。
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