1
|
Cawston H, Bourhis F, Eriksson J, Ruffo P, D'Agostino P, Turini M, Schwartzberg L, McGuire A. NEPA, a new fixed combination of netupitant and palonosetron, is a cost-effective intervention for the prevention of chemotherapy-induced nausea and vomiting in the UK. Drugs Context 2017; 6:212298. [PMID: 28392826 PMCID: PMC5378057 DOI: 10.7573/dic.212298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 12/22/2016] [Indexed: 01/26/2023] Open
Abstract
Background The objective was to evaluate the cost-effectiveness of NEPA, an oral fixed combination netupitant (NETU, 300 mg) and palonosetron (PA, 0.5 mg) compared with aprepitant and palonosetron (APPA) or palonosetron (PA) alone, to prevent chemotherapy-induced nausea and vomiting (CINV) in patients undergoing treatment with highly or moderately emetogenic chemotherapy (HEC or MEC) in the UK. Scope A systematic literature review and meta-analysis were undertaken to compare NEPA with currently recommended anti-emetics. Relative effectiveness was estimated over the acute (day 1) and overall treatment (days 1–5) phases, taking complete response (CR, no emesis and no rescue medication) and complete protection (CP, CR and no more than mild nausea [VAS scale <25 mm]) as primary efficacy outcomes. A three-health-state Markov cohort model, including CP, CR and incomplete response (no CR) for HEC and MEC, was constructed. A five-day time horizon and UK NHS perspective were adopted. Transition probabilities were obtained by combining the response rates of CR and CP from NEPA trials and odds ratios from the meta-analysis. Utilities of 0.90, 0.70 and 0.24 were defined for CP, CR and incomplete response, respectively. Costs included medications and management of CINV-related events and were obtained from the British National Formulary and NHS Reference Costs. The expected budgetary impact of NEPA was also evaluated. Findings In HEC patients, the NEPA strategy was more effective than APPA (quality-adjusted life days [QALDs] of 4.263 versus 4.053; incremental emesis-free and CINV-free days of +0.354 and +0.237, respectively) and was less costly (£80 versus £124), resulting in NEPA being the dominant strategy. In MEC patients, NEPA was cost effective, cumulating in an estimated 0.182 extra QALDs at an incremental cost of £6.65 compared with PA. Conclusion Despite study limitations (study setting, time horizon, utility measure), the results suggest NEPA is cost effective for preventing CINV associated with HEC and MEC in the UK.
Collapse
Affiliation(s)
| | | | | | | | | | - Marco Turini
- Helsinn Healthcare SA, Lugano/Pazzallo, Switzerland
| | | | | |
Collapse
|
2
|
de las Peñas R, Blasco A, De Castro J, Escobar Y, García-Campelo R, Gúrpide A, Lopez-Lopez R, Majem M, Rodríguez CA, Virizuela JA. SEOM Clinical Guideline update for the prevention of chemotherapy-induced nausea and vomiting (2016). Clin Transl Oncol 2016; 18:1237-1242. [PMID: 27896642 PMCID: PMC5138256 DOI: 10.1007/s12094-016-1583-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 11/14/2016] [Indexed: 11/27/2022]
Abstract
Chemotherapy-induced nausea and vomiting is one of the most worrisome adverse effects of chemotherapy for cancer patients. It can cause severe discomfort and affect the quality of life. In recent years, the incorporation of new drugs has increased the efficacy of antiemetic treatments in the control of emesis associated with chemotherapy. This guideline, in which we give some treatment recommendations with level of evidence and grade of recommendation, provides an update of the previously published guideline of the Spanish Society of Medical Oncology and represents our continued commitment to improving supportive care in cancer patients.
Collapse
Affiliation(s)
- R. de las Peñas
- Servicio de Oncología Médica, Consorcio Hospital Provincial de Castellón, Avda. Dr. Clará, 19, 12002 Castellón de la Plana, Castellón Spain
| | - A. Blasco
- Servicio de Oncología Médica, Hospital General Universitario de Valencia, Valencia, Spain
| | - J. De Castro
- Servicio de Oncología Médica, Hospital Universitario la Paz de Madrid, Madrid, Spain
| | - Y. Escobar
- Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón de Madrid, Madrid, Spain
| | - R. García-Campelo
- Servicio de Oncología Médica, Complexo Hospitalario Universitario A Coruña (Hospital Juan Canalejo), A Coruña, Spain
| | - A. Gúrpide
- Servicio de Oncología Médica, Clínica Universitaria de Navarra, Pamplona, Spain
| | - R. Lopez-Lopez
- Servicio de Oncología Médica, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - M. Majem
- Servicio de Oncología Médica, Hospital de la Santa Creu I Sant Pau de Barcelona, Barcelona, Spain
| | - C. A. Rodríguez
- Servicio de Oncología Médica, Hospital Universitario de Salamanca, Salamanca, Spain
| | - J. A. Virizuela
- Servicio de Oncología Médica, Complejo Hospitalario Regional Virgen Macarena de Sevilla, Sevilla, Spain
| |
Collapse
|
3
|
Castro MC, Araújo SAD, Mendes TR, Vilarinho GS, Mendonça MAO. Effectiveness of antiemetics in control of antineoplastic chemotherapy-induced emesis at home. ACTA PAUL ENFERM 2014. [DOI: 10.1590/1982-0194201400069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective Evaluating if antiemetics are effective in the prevention or treatment at home, of chemotherapy-induced emesis. Methods In total, were included 42 women with breast cancer in moderately emetogenic chemotherapy, using dexamethasone/ondansetron before each cycle. The frequency of nausea and vomiting was obtained by applying the instrument in the pre-chemotherapy period, and 24h, 48h, 72h and 96h after chemotherapy. The use of antiemetics was considered in accordance with adherence to medical prescription. Results All patients (n = 42, 100%) reported emesis at some point. Only five cases (11.9%) were anticipatory. In the first 24 hours (acute emesis), 38 (90.5%)ayed), emesis was reported by all despite the regular use (n = 20, 47.6%) or not (n = 22, 52.4%) of antiemetics (ondansetron, dexamethasone and metoclopramide/or dimenhydrinate). Conclusion Antiemetics were not effective in the prevention or treatment at home, of chemotherapy-induced emesis.
Collapse
|
4
|
Dupuis LL, Robinson PD, Boodhan S, Holdsworth M, Portwine C, Gibson P, Phillips R, Maan C, Stefin N, Sung L. Guideline for the prevention and treatment of anticipatory nausea and vomiting due to chemotherapy in pediatric cancer patients. Pediatr Blood Cancer 2014; 61:1506-12. [PMID: 24753095 DOI: 10.1002/pbc.25063] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/18/2014] [Indexed: 11/06/2022]
Abstract
This guideline provides an approach to the prevention and treatment of anticipatory chemotherapy-induced nausea and vomiting (CINV) in children. It was developed by an international, inter-professional panel using AGREE II methods and is based on systematic literature reviews. Evidence-based recommendations for pharmacological and non-pharmacological interventions to prevent and treat anticipatory CINV in children receiving antineoplastic agents are provided. Gaps in the evidence used to support the recommendations are identified. The contribution of this guideline to anticipatory CINV control in children requires prospective evaluation.
Collapse
Affiliation(s)
- L. Lee Dupuis
- Department of Pharmacy; The Hospital for Sick Children; Toronto Ontario
- Leslie Dan Faculty of Pharmacy; University of Toronto; Toronto Ontario
- Program in Child Health Evaluative Sciences; Research Institute, The Hospital for Sick Children; Toronto Ontario
| | | | - Sabrina Boodhan
- Department of Pharmacy; The Hospital for Sick Children; Toronto Ontario
- Leslie Dan Faculty of Pharmacy; University of Toronto; Toronto Ontario
| | - Mark Holdsworth
- College of Pharmacy; University of New Mexico; Albuquerque New Mexico
| | - Carol Portwine
- Division of Hematology/Oncology, Department of Pediatrics; McMaster University; Hamilton Ontario
| | - Paul Gibson
- Pediatric Hematology/Oncology, Children's Hospital; London Health Sciences Centre; London Ontario
| | - Robert Phillips
- Regional Department of Haematology and Oncology; Leeds Children's Hospital; Leeds United Kingdom
- Centre for Reviews and Dissemination; University of York; York United Kingdom
| | - Cathy Maan
- Pediatric Hematology/Oncology, Children's Hospital; London Health Sciences Centre; London Ontario
| | - Nancy Stefin
- Division of Hematology/Oncology, Department of Pediatrics; McMaster University; Hamilton Ontario
| | - Lillian Sung
- Division of Haematology/Oncology; The Hospital for Sick Children; Toronto Ontario
- Program in Child Health Evaluative Sciences; Research Institute, The Hospital for Sick Children; Toronto Ontario
- Department of Paediatrics; University of Toronto; Toronto Ontario
| |
Collapse
|
5
|
Sadaba B, del Barrio A, Campanero MA, Azanza JR, Gomez-Guiu A, Lopez-Picazo JM, Algarra SM, Grimá FG, Prieto MB, Perez-Gracia JL, Gurpide A. Randomized pharmacokinetic study comparing subcutaneous and intravenous palonosetron in cancer patients treated with platinum based chemotherapy. PLoS One 2014; 9:e89747. [PMID: 24587006 PMCID: PMC3937332 DOI: 10.1371/journal.pone.0089747] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 01/17/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Palonosetron is a potent second generation 5- hydroxytryptamine-3 selective antagonist which can be administered by either intravenous (IV) or oral routes, but subcutaneous (SC) administration of palonosetron has never been studied, even though it could have useful clinical applications. In this study, we evaluate the bioavailability of SC palonosetron. PATIENTS AND METHODS Patients treated with platinum-based chemotherapy were randomized to receive SC or IV palonosetron, followed by the alternative route in a crossover manner, during the first two cycles of chemotherapy. Blood samples were collected at baseline and 10, 15, 30, 45, 60, 90 minutes and 2, 3, 4, 6, 8, 12 and 24 h after palonosetron administration. Urine was collected during 12 hours following palonosetron. We compared pharmacokinetic parameters including AUC0-24h, t1/2, and Cmax observed with each route of administration by analysis of variance (ANOVA). RESULTS From October 2009 to July 2010, 25 evaluable patients were included. AUC0-24h for IV and SC palonosetron were respectively 14.1 and 12.7 ng × h/ml (p=0.160). Bioavalability of SC palonosetron was 118% (95% IC: 69-168). Cmax was lower with SC than with IV route and was reached 15 minutes following SC administration. CONCLUSIONS Palonosetron bioavailability was similar when administered by either SC or IV route. This new route of administration might be specially useful for outpatient management of emesis and for administration of oral chemotherapy. TRIAL REGISTRATION ClinicalTrials.gov NCT01046240.
Collapse
Affiliation(s)
- Belen Sadaba
- Clinical Pharmacology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
- * E-mail:
| | - Anabel del Barrio
- Oncology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Miguel Angel Campanero
- Clinical Pharmacology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Jose Ramon Azanza
- Clinical Pharmacology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Almudena Gomez-Guiu
- Clinical Pharmacology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Jose Maria Lopez-Picazo
- Oncology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Salvador Martin Algarra
- Oncology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Francisco Guillén Grimá
- Department of Preventive Medicine, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Maria Blanco Prieto
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Jose Luis Perez-Gracia
- Oncology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| | - Alfonso Gurpide
- Oncology Department, School of Pharmacy, Clinica Universidad Navarra, University of Navarra, Pamplona, Spain
| |
Collapse
|
6
|
Chemotherapy-induced nausea and vomiting: pathophysiology and therapeutic principles. Clin Transl Oncol 2013; 14:413-22. [PMID: 22634529 DOI: 10.1007/s12094-012-0818-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a major determinant of quality of life in cancer patients. In addition, the perceptions that oncology professionals have about CINV quite often do not coincide with reality. Antineoplastic agents and their combinations can be categorised according to their emetogenic level, and this categorisation is helpful for classifying the severity of CINV and treating it. All CINV treatment guidelines emphasise the need to administer prophylaxis to patients who receive highly or moderately emetogenic chemotherapy. With the introduction of NK1 receptor antagonists, the control of acute and delayed CINV after highly or moderately emetogenic chemotherapy schedules has improved in the great majority of patients. NK1 receptor antagonists have been demonstrated to improve the control of CINV in all risk subgroups of patients.
Collapse
|
7
|
The relevance of the Spanish Society for Medical Oncology (SEOM)'s clinical oncology guidelines. Clin Transl Oncol 2010; 12:707-8. [PMID: 20974559 DOI: 10.1007/s12094-010-0582-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|