AHRQ Offers Insight Into Anti-nausea Medications for Patients Undergoing Radiation Therapy

Greater use of aprepitant, an oral anti-nausea medicine, is indicated when it is combined with other anti-emetic medications for preventing the nausea and vomiting caused by cancer treatments, according to a technology assessment report from the Agency for Healthcare Research and Quality (AHRQ).

The AHRQ report compares the benefits and harms of antiemetic regimens that include a 5-HT3 antagonist plus a corticosteroid, both with and without aprepitant, for preventing or treating nausea and vomiting. A literature review found several studies of these medications that the group determined were valid by grading the overall strength of the evidence. Study results were considered valid when they included total control defined as no emetic events, no rescue medication and none to mild nausea or a complete response with no emetic events and no rescue medication.

For total control, the strongest evidence supported significantly increasing a mixed oral and injectable three-drug regimen that contained aprepitant, compared to two-drug combinations without the antiemetic.

“However, in the case where mixed routes were used in patients undergoing primarily highly emetogenic chemotherapy, the benefit of a multi-day, three-drug, aprepitant-containing regimen was minimal during the acute period and only became larger in magnitude during the overall and delayed periods when the control group was administered the 5-HT3 antagonist on day 1 only,” stated the report titled “Consideration of Evidence on Antiemetic Drugs for Nausea and Vomiting Associated With Chemotherapy or Radiation Therapy in Adults.”

The full report can be accessed at http://www.cms.gov/determinationprocess/ downloads/id74ta.pdf.