EFFICACY, SAFETY AND QUALITY OF LIFE OUTCOMES OF PALONOSETRON, RAMOSETRON AND GRANISETRON AS A PART OF ANTIEMETIC THERAPY IN PREVENTION OF CHEMOTHERAPY INDUCED NAUSEA AND VOMITING- A RANDOMISED COMPARATIVE TRIAL
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 24
Abstract
BACKGROUND 5-HT3 receptor antagonists have potent antiemetic effect in chemotherapy induced nausea and vomiting. The present study was conducted to study and compare the efficacy and safety of ramosetron, palonosetron and granisetron in preventing acute and delayed nausea and vomiting in cancer patients receiving moderately emetogenic chemotherapy, and the impact of these drugs on daily living of these patients. MATERIALS AND METHODS It was an open label, randomised, prospective, comparative, parallel study. A total of 59 patients were enrolled in the study. They were divided into 3 groups: palonosetron (0.25mg i.v and 0.5mg orally daily; n=18) group, ramosetron (0.3 mg i.v and 0.1 mg orally daily; n=22) group, and granisetron (1mg i.v and 2mg orally daily; n=19). The drugs were given for 5 days after chemotherapy cycle. In addition, all the three groups received inj. dexamethasone (16mg) prior to chemotherapy and tab. domperidone 10mg orally before chemotherapy and 3 times daily till day 5. The incidence and severity of nausea and vomiting, use of rescue antiemetics and the impact on daily living were evaluated for 7 days. Emetic episodes were recorded on a diary on a daily basis and nausea was measured on a visual analogue scale. Complete response rates (no emesis and no need of rescue antiemetics) were measured as the primary end point. The quality of life outcomes were measured using the functional life index – emesis (FLIE) questionnaire. Safety was evaluated by monitoring the adverse drug reactions of the test drugs. RESULTS The complete response rate in ramosetron group (72.7% in acute; 68.2% in delayed) were numerically better than palonosetron (66.7%; 61.1%) and granisetron (42.1%; 36.8%). The results didn’t achieve statistical significance. The impact on daily living was numerically better in ramosetron than palonosetron and granisetron but the results didn’t show a statistical significance. All the three drugs were well tolerated. CONCLUSION All the three drugs were effective and well tolerated. However, ramosetron showed numerically better complete response rates and better quality of life outcomes as compared to palonosetron and granisetron.
Authors and Affiliations
Seema Gupta, Aman Sharma, Rahul Sharma, Dinesh Kumar, Nusrat Kreem Bhat, Vijay Khajuria
Keywords
Related Articles
- EP ID EP566990
- DOI 10.18410/jebmh/2018/380
- Views 77
- Downloads 0
COMPARATIVE STUDY OF INTRANASAL MIDAZOLAM AND KETAMINE FOR PREMEDICATION IN PAEDIATRIC SURGICAL PATIENTS
BACKGROUND Surgery and anaesthesia cause considerable distress and psychological consequences especially in paediatric patients. The need of the hour is to assess the efficacy of premedicant drugs given through different...
LONG HOSPITAL STAY MAY LEAD TO DEPRESSION?
BACKGROUND A significant percentage of patients admitted in the hospital for some other ailments for duration longer than their expectations may suffer from depression during their hospitalization. Aim of the study is to...
HYPERBARIC BUPIVACAINE WITH FENTANYL COMPARED TO HYPERBARIC BUPIVACAINE ALONE FOR SPINAL ANAESTHESIA IN CAESAREAN SECTION
BACKGROUND Providing anaesthesia for caesarean section is one of the most challenging tasks faced by the anaesthesiologist. If we can add a potent opioid like fentanyl to hyperbaric bupivacaine and thus reduce the dose o...
A PROSPECTIVE, OBSERVATIONAL STUDY TO UNDERSTAND THE DRUG USAGE COMPOSITION OF ANTI-DIABETIC MEDICATIONS IN A RURAL CENTRE IN KERALA
BACKGROUND With exponentially higher number of patients being diagnosed with diabetes in India, it has gained an epidemic status here.1,2 Globally, the prevalence of diabetes in 2030 is expected to be almost double that...
ASSESSMENT OF PREVALENCE OF CONGENITAL HEARING LOSS IN NEONATES BY OTOACOUSTIC EMISSIONS IN KONASEEMA REGION
BACKGROUND Hearing impairment is one of the commonest congenital disabilities in the world. The prevalence of congenital hearing loss has been estimated to be 1.2-5.7 per 1,000 live births and is more among high risk neo...