| アブストラクト | BACKGROUND: Cisplatin (CDDP)-induced nephrotoxicity is the most important complication of CDDP treatment. 5-Hydroxytryptamine type 3 receptor antagonists (5-HT3RAs) are widely used to prevent chemotherapy-induced nausea and vomiting (CINV). However, in patients with the triple antiemetic (neurokinin-1 receptor antagonist, 5-HT3RA, and dexamethasone) therapy, the advantage of palonosetron in comparison with other 5-HT3RAs on CDDP-induced nephrotoxicity and CINV remains unclear. In the present study, we investigated the effect of palonosetron on CDDP-induced nephrotoxicity and CINV in patients with the triple antiemetic therapy by a retrospective cohort study and a pharmacovigilance analysis. METHODS: We retrospectively analyzed the effect of 5-HT3RAs on the development of nephrotoxicity and CINV in 110 patients who received CDDP, fluorouracil, and triple antiemetic therapy for the treatment of esophageal cancer. Moreover, the effect of 5-HT3RAs on CDDP-induced nephrotoxicity was validated in patients with the triple antiemetic therapy using the Japanese Adverse Drug Event Report (JADER) database. RESULTS: In a retrospective study, the incidence of nephrotoxicity (>/= grade 1) in patients receiving palonosetron (18%) was significantly lower than that in patients receiving ramosetron (another 5-HT3RA) (36%, p = 0.044). Moreover, severe nephrotoxicity >/= grade 3 was observed in one patient treated with ramosetron, whereas hematological toxicity was comparable between the two groups (p = 0.553). Furthermore, the incidence rate of CINV within 120 h following CDDP administration in patients treated with palonosetron (18%) was significantly lower than that in patients receiving ramosetron (39%, p = 0.026). JADER database analyses revealed that the reporting odds ratio of palonosetron for CDDP-induced acute kidney injury was 0.282 (95% confidence interval: 0.169-0.472). CONCLUSIONS: The findings of the present study suggested a greater potential of palonosetron against CDDP-induced nephrotoxicity and CINV than other 5-HT3RAs in patients with the triple antiemetic therapy. |
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| ジャーナル名 | Journal of pharmaceutical health care and sciences |
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| Pubmed追加日 | 2022/8/1 |
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| 投稿者 | Takemura, Miho; Ikemura, Kenji; Kondo, Masayoshi; Yamane, Fumihiro; Ueda, Mikiko; Okuda, Masahiro |
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| 組織名 | Department of Clinical Pharmacy Research and Education, Graduate School of;Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, 565-0871,;Japan.;Department of Pharmacy, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka,;565-0871, Japan. ikemurak@hp-drug.med.osaka-u.ac.jp.;Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences,;Osaka University, 1-6 Yamadaoka, Suita, Osaka, 565-0871, Japan.;ikemurak@hp-drug.med.osaka-u.ac.jp.;565-0871, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35909131/ |
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