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Published on: June 21, 2024
Olanzapine Prophylaxis for Opioid-Induced Nausea and Vomiting: A Single-Arm Exploratory Study
Eriko Satomi1, Naho Matsubara2, Rumi Nishimura3
1Department of Palliative Medicine (E.S., N.M., R.N., A.A., N.K., S.A., H.I.), National Cancer Center Hospital, Tokyo, Japan; Department of Palliative Medicine (E.S., N.K., T.T., A.M.), Juntendo University Graduate School of Medicine, Tokyo, Japan.
Olanzapine effectively prevented opioid-induced nausea and vomiting (OINV) in cancer patients, demonstrating high complete control and response rates with good tolerability. Further research is recommended to confirm these promising findings for OINV prophylaxis.
Area of Science:
- Oncology
- Pharmacology
- Gastroenterology
Background:
- Opioid-induced nausea and vomiting (OINV) affects a significant portion of patients, with current antiemetic prophylaxis showing uncertain efficacy and safety.
- Olanzapine, effective for chemotherapy-induced nausea and vomiting, presents a potential prophylactic option for OINV.
Purpose of the Study:
- To evaluate the efficacy and safety of olanzapine for preventing nausea and vomiting in cancer patients initiating opioid therapy.
- To assess the complete control (CC) and complete response (CR) rates of olanzapine in OINV prophylaxis.
Main Methods:
- A single-arm, single-center exploratory study involving 34 cancer patients receiving 5 mg of olanzapine daily for 5 days.
- Primary endpoint: complete control rate (no emesis, no rescue antiemetics, minimal nausea).
- Secondary endpoints: complete response rate (no emesis, no rescue antiemetics) and adverse events (CTCAE ver.5.0).
Main Results:
- Complete control (CC) was achieved in 79.4% of patients (p=0.0527), and complete response (CR) in 82.4% (p=0.0390).
- 85.3% of patients experienced no emetic events.
- No serious adverse events were reported during the study.
Conclusions:
- Olanzapine appears to be an effective and well-tolerated prophylactic agent for opioid-induced nausea and vomiting in cancer patients.
- Further confirmatory clinical trials are warranted to validate these findings.
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