Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.

Netupitant-palonosetron combo + dexamethasone may prevent chemo-induced nausea, vomiting

Audrey Abella
02 May 2018

A single administration of the fixed-dose combination consisting of netupitant plus palonosetron (NEPA) in addition to dexamethasone may be an effective strategy for preventing chemotherapy-induced nausea and vomiting (CINV) among breast cancer patients receiving combination chemotherapy consisting of anthracycline and cyclophosphamide (AC), according to results from the GIM15-NEPA* trial presented at EBCC 2018.

A triple-drug combination consisting of an NK1RA**, a 5-HT3RA***, and dexamethasone is particularly recommended for breast cancer patients receiving AC-based chemotherapy to prevent CINV, which is likely to occur following chemotherapy due to the highly emetogenic nature of the agents used, noted the researchers.

NEPA is the first oral combination antiemetic that fulfils this requirement for the prevention of acute and delayed CINV as it consists of the highly selective NK1RA netupitant, and the 5-HT3RA palonosetron, said the researchers.

This open-label, multicentre study evaluated the efficacy of oral NEPA and dexamethasone 12 mg on 146 breast cancer patients undergoing AC-based chemotherapy. The antiemetic agents were administered on day 1 before each AC chemotherapy commenced, for a maximum of four cycles. The primary endpoint was the achievement of a complete response (CR), which pertains to the lack of emetic episode as well as the nonuse of rescue medication during the overall phase (0–120 hours) after the four cycles of chemotherapy. [EBCC-11, abstract PB-110]

The primary endpoint was achieved throughout all cycles (overall CR, 0.705, 90 percent confidence limit [CL], 0.641–0.769 for the first and second cycles; 0.724, 90 percent CL, 0.662–0.787 and 0.705, 90 percent CL, 0.642–0.770 for the third and fourth cycles, respectively).

NEPA was also well-tolerated, and most adverse events (AEs) were mild to moderate in intensity, which is consistent with the SmPC#-documented safety profile of NEPA, noted the researchers. The most common drug-related AE was fatigue (3.4 percent), followed by anaemia (2.7 percent), headache (2.1 percent), and reduction in neutrophil count (1.4 percent).

“[T]his study [demonstrated] a clinically relevant efficacy of one-day NEPA plus dexamethasone in preventing [CINV] during the entire period of … AC-based chemotherapy,” said the researchers.

These findings are consistent with evidence highlighting NEPA as a convenient, safe, and effective prophylactic antiemetic therapy for CINV, given its potential to target two antiemetic pathways with only a single dose. [Support Care Cancer 2018;26:1151-1159]

 

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.