By Ed Susman
SAN DIEGO, CA -- May 9, 2007 -- The antiemetic agent aprepitant appears to be more effective in controlling the nausea and vomiting that follow surgery than the standard treatment with ondansetron, doctors said here at the 55th annual clinical meeting of the American College of Obstetricians and Gynecologists (ACOG).
In the study, the 40 mg dose of aprepitant achieved statistically significant advantages over ondansetron in all five endpoints, reported Keith Candiotti, MD, director of research and associate professor of anaesthesiology, University of Miami Jackson Memorial Hospital, Miami, Florida, United States.
"In the post hoc combined analysis of nearly 1,600 surgical inpatients in the first 24 hours after general anaesthesia, aprepitant provided better protection against vomiting, significant nausea, and the combination of nausea, vomiting and the need for rescue therapy," Dr. Candiotti said in his poster presentation on May 7th.
Patients were recruited to receive 40 mg aprepitant, 125 mg aprepitant or 4 mg ondansetron.
In the first two hours after awakening from general anaesthesia, 8.8% of patients given ondansetron experienced vomited episodes, compared to 2.4% of those on aprepitant 40 mg, Dr. Candiotti noted.
In the study, 56.4% of the 541 patients on aprepitant 40 mg (P =.009) had no significant nausea (0-4 scores on the 11-point verbal rating scale) compared with 55.1% of 532 patients on aprepitant 125 mg (P =.027) and 48.1% of 526 patients on ondansetron.
No nausea was reported by 39.6% of patients on aprepitant 40 mg (P =.035), 36.5% of patients on aprepitant 125 mg (P = NS) and 33.1% of patients on ondansetron.
No vomiting was reported by 86.7% of patients on aprepitant 40 mg (P <.001), 90.2% of patients on aprepitant 125 mg (P <.001) and 72.4% of patients on ondansetron.
No nausea or vomiting was reported by 38.3% of patients on aprepitant 40 mg (P =.023), 35.9% of patients on aprepitant 125 mg (P = NS) and 31.4% of patients on ondansetron.
No nausea, vomiting or the need for rescue medication was reported by 37.9% of patients on aprepitant 40 mg (P =.027), 35.3% of patients on aprepitant 125 mg (P = NS) and 31.2% of patients on ondansetron.
Aprepitant is a selective, brain penetrant neurokinin-1 antagonist currently used to prevent chemotherapy induced nausea and vomiting and postoperative nausea and vomiting.
The study was supported by Merck, the maker of aprepitant (Emend)
[Presentation title: The NK1 Antagonist Aprepitant Compared With the 5HT3 Antagonist Ondansetron for Prevention of Postoperative Nausea and Vomiting. Abstract 37 (May 7)]
E-Mail this DGDispatch to a colleague
