Evaluation of aprepitant as an add-on therapy for prevention of chemotherapy induced nausea and vomiting in children

Authors

  • Tapas Chowdhury Department of Pediatrics and Neonatology, Bangladesh Specialized Hospital, Dhaka, Bangladesh
  • M. Anwarul Karim Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Tania Sultana Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Farzana Sharmin Department of Pediatrics, 100 Beded District Hospital, Narsingdi, Bangladesh
  • Zamil Ahmed Manik Department of Pediatrics, Institute of Child and Mother Health, Dhaka, Bangladesh
  • Umme Nusrat Ara Department of Pediatric Hematology and Oncology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
  • Sharmin Akhter Department of Hematology and Bone Marrow Transplantation, Asgar Ali Hospital, Dhaka, Bangladesh
  • Jesmine Akter Department of Pediatrics and Neonatology, Bangladesh Specialized Hospital, Dhaka, Bangladesh
  • Farzana Alam Mou Department of Hematology and Stem Cell Transplant, Evercare Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233952

Keywords:

Aprepitant, Prevention, Chemotherapy, Nausea, Vomiting, Children

Abstract

Background: Chemotherapy-induced nausea and vomiting (CINV), represents a common and distressing side effect associated with antineoplastic treatment in pediatric patients. Aprepitant, a selective neurokinin-1 receptor antagonist, is recommended for preventing CINV in combination with a standard antiemetic regimen in children undergoing chemotherapy. This study aimed to evaluate the effectiveness of aprepitant as an add-on therapy to the standard antiemetic regimen for the prevention of CINV in children.

Methods: This randomized control study was conducted in the BSMMU, Dhaka, Bangladesh from February 2020 to October 2020. Forty-six children with malignancy undergoing chemotherapy were divided into two arms: the Aprepitant arm (23 patients receiving granisetron, dexamethasone, and aprepitant) and the control arm (23 patients receiving Granisetron and Dexamethasone). Data were analyzed using SPSS version 22.0.

Results: The complete response rates for the aprepitant versus control arm during the acute and overall phase were 82% vs. 40% (p=0.003) and 65% vs. 26% (p=0.008), respectively. However, a higher percentage of patients who achieved complete response in the delayed phase was also observed, though statistically not significant (65% vs 40%, p=0.077). In the acute phase, there was a significant reduction in mild to moderate vomiting in the Aprepitant arm as compared to the control arm (p=0.01). In the overall phase, 35% of patients in the Aprepitant arm had mild to moderate vomiting as compared to 74% in the control group (p=0.027). No major adverse effects were reported by patients or caregivers.

Conclusions: Adding Aprepitant to the standard antiemetic regimen was effective and safe in preventing CINV, especially in the acute phase, in pediatric patients receiving the moderately and highly emetogenic chemotherapy (HEC).

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Published

2023-12-28

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Original Research Articles