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

Tapas Chowdhury; M. Anwarul Karim; Tania Sultana; Farzana Sharmin; Zamil Ahmed Manik; Umme Nusrat Ara; Sharmin Akhter; Jesmine Akter; Farzana Alam Mou

doi:10.18203/2349-3291.ijcp20233952

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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