Efficacy and safety of aprepitant in the prevention of chemotherapy-induced nausea and vomiting: a pooled analysis

Support Care Cancer. 2012 Aug;20(8):1815-22. doi: 10.1007/s00520-011-1280-z. Epub 2011 Oct 5.

Abstract

Purpose: A number of studies have reported that aprepitant has been used to prevent chemotherapy-induced nausea and vomiting. In this study, we aimed to analyze the efficacy and safety of aprepitant, which can provide evidence for aprepitant administration.

Materials and methods: Fifteen trials involving patients who received moderately or highly emetogenic chemotherapy were included in this pooled analysis. Antiemetic drugs in these studies included aprepitant, dexamethasone, and 5-HT3 receptor antagonists.

Results: A total of 4,798 cases were investigated in these clinical trials. Compared with placebo or the standard antiemetic therapy, the cumulative incidence of emesis was significantly reduced in the patients treated with aprepitant-based (125 mg/80 mg) therapy on the first day [relative risk (RR) = 1.13, 95% confidence interval (CI) 1.10-1.16], from 2 to 5 days (RR = 1.35, 95% CI 1.22-1.48) and in the overall 5 days (RR = 1.30, 95% CI 1.22-1.39). In terms of drug safety, there was no significant difference between aprepitant-based regimens and non-aprepitant regimens.

Conclusion: Results from the analysis suggest that aprepitant with 5-HT3 receptor antagonists and dexamethasone is highly effective in preventing nausea and vomiting in the days after administration of moderately or highly emetogenic chemotherapy (MEC or HEC) agents.

MeSH terms

  • Antiemetics / therapeutic use*
  • Antineoplastic Agents / adverse effects*
  • Aprepitant
  • Dexamethasone / therapeutic use
  • Humans
  • Morpholines / therapeutic use*
  • Nausea / chemically induced*
  • Nausea / prevention & control*
  • Serotonin 5-HT3 Receptor Antagonists / therapeutic use
  • Treatment Outcome
  • Vomiting / chemically induced*
  • Vomiting / prevention & control*

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Morpholines
  • Serotonin 5-HT3 Receptor Antagonists
  • Aprepitant
  • Dexamethasone