Svanberg, A., & Birgegard, G. (2015). Addition of aprepitant (Emend®) to standard antiemetic regimen continued for 7 days after chemotherapy for stem cell transplantation provides significant reduction of vomiting. Oncology, 89, 31–36.
To evaluate the effectiveness of adding aprepitant to standard antiemetic treatment in patients receiving high-dose chemotherapy prior to stem cell transplantation
This was a randomized, blinded study.
Patient diaries were used to record nausea and vomiting. An analysis was made on an intention-to-treat basis, and differences between the groups were then analyzed. Days at the hospital, weight, and use of total parenteral nutrition also were analyzed.
Thirty-eight patients (83%) in the experimental group experienced no vomiting compared to 16 patients (36%) in the control group. This finding was statistically significant. The number of vomiting episodes was also significantly lower in the experimental arm compared to the control arm up to 17 days post chemotherapy. There were no significant differences regarding days of nausea or use of antiemetic rescue medications between the two groups. There were no significant differences noted in days at the hospital, weight and use of TPN between the two groups.
The results also showed that there was a significant difference between patients who expected nausea and those who did not. Patients who did not expect nausea had lower rates of vomiting as well as fewer days of nausea.
The addition of aprepitant to the antiemetic regimen in this patient population was well-tolerated and demonstrated a statistically significant reduction in the rate of delayed vomiting.
Delayed CINV is an issue of critical importance for this patient population, and ongoing research to identify and improve symptom control and quality of life is necessary. These findings provide a springboard to conduct additional research with a larger sample size to confirm the positive impact of aprepitant on delayed vomiting.