内容紹介
Appropriate Dosing of Fosaprepitant for Colon Cancer Patients
Summary
After fosaprepitant(FOS)was added to the National Health Insurance drug reimbursement price list, we switched the route of administration of antiemetics from oral to intravenous in chemotherapy regimens for colon cancer to improve patient medication adherence. However, because the number of patients reporting application-site disorders after administration of FOS increased, we monitored the incidence of these disorders in patients with colon cancer to identify ways to avoid them. In our prospective study, patients receiving conventional FOS dosing regimens(control group)were compared with those receiving diluted FOS solutions(study group). There were no significant differences between the two groups with respect to the incidence of application-site disorders, and contrary to expectations, the incidence was higher in the study group than in the control group. On the basis of the principle of non-maleficence and the availability of alternative therapies using oral aprepitant(APR), we terminated this study early and adopted the basic strategy that all patients with application-site disorders, except for those with central venous access devices, should be treated with oral APR after confirming their preferences.
要旨
ホスアプレピタント(以下,FOS)が保険収載され,当院ではアドヒアランス向上の面から大腸癌化学療法レジメンの制吐剤を経口から静注に全面切り替えをした。しかし,末梢からのFOS投与により投与部位反応を訴える患者を経験した。今回,FOSの投与部位反応の実態を把握するとともに回避策についても検討した。従来のFOS投与方法を通常群とし希釈群を試験群として前向きに検討したところ,2群間に投与部位反応の発現頻度に有意差はなく希釈群のほうが通常群よりも高い傾向となった。この結果より,当院では無危害原則から逸脱していること,および経口薬アプレピタント(以下,APR)による代替治療があることから研究を早期中止とし,患者希望を伺った上で経口薬投与を原則とした。
目次
Summary
After fosaprepitant(FOS)was added to the National Health Insurance drug reimbursement price list, we switched the route of administration of antiemetics from oral to intravenous in chemotherapy regimens for colon cancer to improve patient medication adherence. However, because the number of patients reporting application-site disorders after administration of FOS increased, we monitored the incidence of these disorders in patients with colon cancer to identify ways to avoid them. In our prospective study, patients receiving conventional FOS dosing regimens(control group)were compared with those receiving diluted FOS solutions(study group). There were no significant differences between the two groups with respect to the incidence of application-site disorders, and contrary to expectations, the incidence was higher in the study group than in the control group. On the basis of the principle of non-maleficence and the availability of alternative therapies using oral aprepitant(APR), we terminated this study early and adopted the basic strategy that all patients with application-site disorders, except for those with central venous access devices, should be treated with oral APR after confirming their preferences.
要旨
ホスアプレピタント(以下,FOS)が保険収載され,当院ではアドヒアランス向上の面から大腸癌化学療法レジメンの制吐剤を経口から静注に全面切り替えをした。しかし,末梢からのFOS投与により投与部位反応を訴える患者を経験した。今回,FOSの投与部位反応の実態を把握するとともに回避策についても検討した。従来のFOS投与方法を通常群とし希釈群を試験群として前向きに検討したところ,2群間に投与部位反応の発現頻度に有意差はなく希釈群のほうが通常群よりも高い傾向となった。この結果より,当院では無危害原則から逸脱していること,および経口薬アプレピタント(以下,APR)による代替治療があることから研究を早期中止とし,患者希望を伺った上で経口薬投与を原則とした。