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Global experience with ondansetron and future potential
1Glaxo Group Research, Greenford, Middlesex, UK.
Abstract:
Ondansetron was first synthesised in 1983 and it is estimated that over 4 million patient treatments have been given with ondansetron in clinical practice. Clinical trials in over 15,000 patients have demonstrated that ondansetron is effective and well tolerated in a range of clinical settings, including adults and children and over repeated courses of treatment. Ondansetron is convenient to administer, being effective as a single intravenous dose for the control of acute emesis and as oral therapy on a twice-daily schedule. Recent studies have also shown it to be a cost-effective anti-emetic when the costs of treatment failure of traditional anti-emetics are taken into account. Studies have also demonstrated an improved quality of life with ondansetron compared to treatment with metoclopramide. Ondansetron has also been found to be effective in the prevention or treatment of postoperative nausea and vomiting and other studies are underway to investigate its potential use in other clinical settings. Furthermore, appropriately designed trials are ongoing to evaluate the place of ondansetron in the control of cisplatin-induced delayed emesis. In conclusion, ondansetron has been shown to be a major advance in the control of nausea and vomiting associated with chemotherapy and radiotherapy.
Insights
Ondansetron effectively controls nausea and vomiting from chemotherapy and radiotherapy. This anti-emetic is well-tolerated, cost-effective, and improves patient quality of life.
Area of Science:
- Pharmacology
- Clinical Medicine
- Oncology Supportive Care
Background:
- Ondansetron, synthesized in 1983, has been administered in over 4 million patient treatments.
- Clinical trials involving over 15,000 patients confirm its efficacy and tolerability.
- It offers convenient administration options, including intravenous and oral formulations.
Purpose of the Study:
- To evaluate the effectiveness and tolerability of ondansetron in managing chemotherapy- and radiotherapy-induced nausea and vomiting (CINV/RINV).
- To assess the cost-effectiveness and impact on quality of life compared to traditional anti-emetics.
- To explore its utility in other clinical settings, such as postoperative nausea and vomiting (PONV) and cisplatin-induced delayed emesis.
Main Methods:
- Clinical trials encompassing diverse patient populations (adults and children) and treatment scenarios.
- Comparative studies assessing quality of life against metoclopramide.
- Cost-effectiveness analyses considering treatment failure costs of alternative anti-emetics.
Main Results:
- Ondansetron demonstrates significant efficacy and good tolerability across various clinical settings and treatment durations.
- It provides effective control of acute emesis with single intravenous doses and twice-daily oral therapy.
- Studies indicate improved quality of life and cost-effectiveness compared to metoclopramide and traditional anti-emetics.
Conclusions:
- Ondansetron represents a major advancement in controlling nausea and vomiting associated with chemotherapy and radiotherapy.
- Its efficacy, tolerability, convenience, and cost-effectiveness support its widespread clinical use.
- Ongoing research continues to explore its full therapeutic potential in diverse emetogenic conditions.