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Evaluation of aprepitant and fosaprepitant in pediatric patients
Author(s) -
Saito Yoshimasa,
Kumamoto Tadashi,
Arima Takamichi,
Shirakawa Nami,
Ishimaru Sae,
Sonoda Tomoko,
Nakajima Miho,
Sugiyama Masanaka,
Arakawa Ayumu,
Hashimoto Hironobu,
Makino Yoshinori,
Ogawa Chitose,
Yamaguchi Masakazu
Publication year - 2019
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13780
Subject(s) - aprepitant , medicine , vomiting , nausea , adverse effect , chemotherapy induced nausea and vomiting , chemotherapy , clinical endpoint , gastroenterology , oncology , anesthesia , clinical trial , antiemetic
Background Single‐dose i.v. fosaprepitant has been approved as an alternative to 3 day oral aprepitant, a neurokinin‐1 receptor antagonist, and improves prevention of chemotherapy‐induced nausea and vomiting ( CINV ). Because fosaprepitant has shown similar efficacy to aprepitant in adult patients only, this study compared the efficacy and safety of aprepitant and fosaprepitant in pediatric patients. Methods Children younger than 18 years who received aprepitant or fosaprepitant to manage CINV between January 2015 and March 2018 at the National Cancer Center Hospital (Tokyo) were recruited to this study. The primary endpoint was complete response ( CR ; no vomiting/rescue medication) between 0 and 120 h after the start of chemotherapy. Secondary endpoints were safety based on the frequency of severe adverse events, and evaluation of patient characteristics as risk factors (effect of age and sex). Results A total of 125 chemotherapy cycles were evaluated. In the aprepitant group, CR was observed in 36 of 80 treatment cycles (45.0%), whereas in the fosaprepitant group, it was observed in 19 of 45 cycles (42.2%; P = 0.852). No treatment‐related severe adverse events were observed in either group. The number of non‐ CR was greater than that of CR in patients aged 6–14 years. The difference in CR rate between male and female patients was not statistically significant (47.1% vs 40.0%, respectively; P = 0.471). Conclusions Aprepitant and fosaprepitant were safely used and may be equally useful for pediatric patients receiving highly emetogenic chemotherapy. CR rate may be associated with patient age.