Yeh, Y.C., McDonnell, A., Klinger, E., Fowler, B., Matta, L., Voit, D., & Reddy, P. (2011). Comparison of healthcare resource use between patients receiving ondansetron or palonosetron as prophylaxis for chemotherapy-induced nausea and vomiting. Journal of Oncology Pharmacy Practice, 17(3), 179–185.
To analyze the differences between ondansetron and palonosetron in healthcare resource use (i.e., inpatient/outpatient encounters) among patients receiving intraperitoneal (IP) cisplatin
This study reported on a review of an electronic medical record system. Key variables were patient characteristics, chemotherapy regimen, diagnosis, medications, type of 5-HT3 receptor antagonist (RA), other healthcare resource use, and reasons for use.
This was a single-site, inpatient and outpatient study conducted in Massachusetts.
This was an observational study (electronic chart review).
The following were recorded.
More CINV-related hospitalizations were found with ondansetron versus palonosetron (5.1% vs. 0%, p = 0.09) with no significant difference in other CINV-related encounters. Palonosetron was always administered as single-day therapy; ondansetron was administered as one-day (27%) or multiday (73%) therapy. No significant differences were found in hospital readministrations, emergency department visits, outpatient visits, or switches to alternate 5-HT3 RAs between palonosetron and ondansetron. When CINV-related resource use was compared, a trend to more hospitalization was noted in the ondansetron arm, although it was not significant (2 out of 39 in the ondansetron arm versus 0 out of 89 in the palonosetron arm).
Palonosetron was associated with a trend to a lower risk of CINV-related hospital readmission than ondansetron in patients receiving IP cisplatin for gynecological cancers; however, the trend was not statistically significant. The duration of ondansetron therapy might be suboptimal with 27% of patients receiving only one day of therapy during hospital stay.
Because of the design and limitations, this study does not help in building evidence for the conclusion that palonosetron has a lower risk of CINV-related readmission compared to ondansetron.