PubMed:21711119 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PubMed/sourceid/21711119","sourcedb":"PubMed","sourceid":"21711119","source_url":"http://www.ncbi.nlm.nih.gov/pubmed/21711119","text":"Impact of 5-HT(3) RA selection within triple antiemetic regimens on uncontrolled highly emetogenic chemotherapy-induced nausea/vomiting.\nBACKGROUND: It is recommended that patients initiate triple antiemetic therapy with one of the 5-hydroxytryptamine receptor antagonists (5-HT(3) RAs), aprepitant (or its intravenous prodrug fosaprepitant) and dexamethasone prior to the start of highly emetogenic chemotherapy (HEC). However, the impact of 5-HT(3) RA selection within triple antiemetic regimens on the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) with HEC has not been well studied.\nAIM: To assess the likelihood of an uncontrolled CINV event following antiemetic prophylaxis with the 5-HT(3) RA palonosetron + aprepitant/fosaprepitant + dexamethasone (palonosetron cohort) versus any of the other 5-HT(3) RAs + aprepitant/fosaprepitant + dexamethasone (other 5-HT(3) RA cohort) among single-day HEC cycles.\nMETHODS: Single-day HEC cycles (a gap of at least 5 days between two administrations) among patients with a cancer diagnosis and receiving antiemetic prophylaxis with the aforementioned regimens between 1/1/2006 and 6/30/2010 were identified from the IMS LifeLink claims database. Uncontrolled CINV events were identified through ICD-9-CM codes (nausea and vomiting), Current Procedural Terminology codes (hydration), rescue medications and/or use of antiemetic therapy from days 2-5 following HEC administration. Risks for an uncontrolled CINV event among all patients, and within breast cancer and multiple cancer subpopulations, were analyzed at cycle level using logistic multivariate regression models.\nRESULTS: A total of 8018 cycles for the palonosetron cohort and 1926 cycles for the other 5-HT(3) RA cohort (3574 and 978 patients, respectively) were analyzed. Single-day HEC cycles received by the palonosetron cohort had a significantly lower unadjusted risk of an uncontrolled CINV event (17.5 vs 20.7% for the other 5-HT(3) RA cohort; p = 0.0010), with a 17% lower adjusted risk for palonosetron-administered cycles (odds ratio: 0.83; 95% CI: 0.73-0.94; p = 0.0042). Results in the breast cancer and multiple cancer subgroups were consistent with those for the overall population.\nCONCLUSION: In this retrospective claims data analysis, single-day HEC cycles administered with palonosetron + aprepitant/fosaprepitant + dexamethasone had a lower risk for an uncontrolled CINV event versus other 5-HT(3) RAs + aprepitant/fosaprepitant + dexamethasone.","tracks":[{"project":"Allie","denotations":[{"id":"SS1_21711119_2_0","span":{"begin":382,"end":412},"obj":"expanded"},{"id":"SS2_21711119_2_0","span":{"begin":414,"end":417},"obj":"abbr"},{"id":"SS1_21711119_3_0","span":{"begin":526,"end":566},"obj":"expanded"},{"id":"SS2_21711119_3_0","span":{"begin":568,"end":572},"obj":"abbr"}],"relations":[{"id":"AE1_21711119_2_0","pred":"abbreviatedTo","subj":"SS1_21711119_2_0","obj":"SS2_21711119_2_0"},{"id":"AE1_21711119_3_0","pred":"abbreviatedTo","subj":"SS1_21711119_3_0","obj":"SS2_21711119_3_0"}],"attributes":[{"subj":"SS1_21711119_2_0","pred":"source","obj":"Allie"},{"subj":"SS2_21711119_2_0","pred":"source","obj":"Allie"},{"subj":"SS1_21711119_3_0","pred":"source","obj":"Allie"},{"subj":"SS2_21711119_3_0","pred":"source","obj":"Allie"}]},{"project":"PubmedHPO","denotations":[{"id":"T1","span":{"begin":547,"end":553},"obj":"HP_0002018"},{"id":"T2","span":{"begin":558,"end":566},"obj":"HP_0002013"}],"attributes":[{"subj":"T1","pred":"source","obj":"PubmedHPO"},{"subj":"T2","pred":"source","obj":"PubmedHPO"}]},{"project":"PubMed_Structured_Abstracts","denotations":[{"id":"T1","span":{"begin":149,"end":609},"obj":"BACKGROUND"},{"id":"T2","span":{"begin":615,"end":934},"obj":"OBJECTIVE"},{"id":"T3","span":{"begin":944,"end":1642},"obj":"METHODS"},{"id":"T4","span":{"begin":1652,"end":2227},"obj":"RESULTS"},{"id":"T5","span":{"begin":2240,"end":2496},"obj":"CONCLUSIONS"}],"attributes":[{"subj":"T1","pred":"source","obj":"PubMed_Structured_Abstracts"},{"subj":"T2","pred":"source","obj":"PubMed_Structured_Abstracts"},{"subj":"T3","pred":"source","obj":"PubMed_Structured_Abstracts"},{"subj":"T4","pred":"source","obj":"PubMed_Structured_Abstracts"},{"subj":"T5","pred":"source","obj":"PubMed_Structured_Abstracts"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"Allie","color":"#93a2ec","default":true},{"id":"PubmedHPO","color":"#bcec93"},{"id":"PubMed_Structured_Abstracts","color":"#ec93d6"}]}]}}