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Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial.

Publication ,  Journal Article
Gan, TJ; Gu, J; Singla, N; Chung, F; Pearman, MH; Bergese, SD; Habib, AS; Candiotti, KA; Mo, Y; Huyck, S; Creed, MR; Cantillon, M ...
Published in: Anesth Analg
April 2011

BACKGROUND: Postoperative nausea and vomiting (PONV) are common complications after surgery. Neurokinin-1 (NK(1)) receptor antagonists have been shown to be safe and effective for the prevention and treatment of PONV in humans. Rolapitant is a potent, selective NK1 receptor antagonist that is rapidly absorbed, has a remarkably long half-life (up to180 hours), and appears to have a low potential for drug-drug interactions. We evaluated the dose response for rolapitant for the prevention of PONV in subjects at high risk for this condition, and rolapitant's effects on preventing delayed PONV were explored up to 5 days after surgery. METHODS: A randomized, multicenter, double-blind, dose-ranging study of rolapitant was conducted with placebo and active control groups. Six hundred nineteen adult women undergoing open abdominal surgery were randomly assigned in equal ratios to 1 of 6 study arms: oral rolapitant in 5-mg, 20-mg, 70-mg, or 200-mg doses; IV ondansetron 4 mg; or placebo, stratified by history of PONV or motion sickness. The primary study endpoint was absence of emetic episodes, regardless of use of rescue medication, at 24 hours after extubation. RESULTS: Groups assigned to rolapitant 20-mg, 70-mg, and 200-mg had a higher incidence of no emesis in comparison with placebo at 24 hours after surgery. A linear relationship between rolapitant dose and primary outcome was seen. The probability of an emetic episode was significantly lower in the rolapitant 70-mg and 200-mg groups in comparison with placebo (P ≤ 0.001 based on the log-rank test). No significant differences were noted between rolapitant and the active control (ondansetron) at 24 hours after surgery, but there was a higher incidence of no emesis (regardless of rescue medication use) in the rolapitant 200- and 70-mg groups at 72 and 120 hours, respectively. CONCLUSION: Rolapitant is superior to placebo in reducing emetic episodes after surgery and reduces the incidence of vomiting in a dose-dependent manner. No differences in side effect profile were observed between rolapitant and placebo.

Duke Scholars

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

April 2011

Volume

112

Issue

4

Start / End Page

804 / 812

Location

United States

Related Subject Headings

  • Receptors, Neurokinin-1
  • Postoperative Nausea and Vomiting
  • Neurokinin-1 Receptor Antagonists
  • Middle Aged
  • Humans
  • Female
  • Double-Blind Method
  • Dose-Response Relationship, Drug
  • Antiemetics
  • Anesthesiology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gan, T. J., Gu, J., Singla, N., Chung, F., Pearman, M. H., Bergese, S. D., … Rolapitant Investigation Group, . (2011). Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial. Anesth Analg, 112(4), 804–812. https://doi.org/10.1213/ANE.0b013e31820886c3
Gan, Tong J., Jiezhun Gu, Neil Singla, Frances Chung, Michael H. Pearman, Sergio D. Bergese, Ashraf S. Habib, et al. “Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial.Anesth Analg 112, no. 4 (April 2011): 804–12. https://doi.org/10.1213/ANE.0b013e31820886c3.
Gan TJ, Gu J, Singla N, Chung F, Pearman MH, Bergese SD, et al. Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial. Anesth Analg. 2011 Apr;112(4):804–12.
Gan, Tong J., et al. “Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial.Anesth Analg, vol. 112, no. 4, Apr. 2011, pp. 804–12. Pubmed, doi:10.1213/ANE.0b013e31820886c3.
Gan TJ, Gu J, Singla N, Chung F, Pearman MH, Bergese SD, Habib AS, Candiotti KA, Mo Y, Huyck S, Creed MR, Cantillon M, Rolapitant Investigation Group. Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial. Anesth Analg. 2011 Apr;112(4):804–812.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

April 2011

Volume

112

Issue

4

Start / End Page

804 / 812

Location

United States

Related Subject Headings

  • Receptors, Neurokinin-1
  • Postoperative Nausea and Vomiting
  • Neurokinin-1 Receptor Antagonists
  • Middle Aged
  • Humans
  • Female
  • Double-Blind Method
  • Dose-Response Relationship, Drug
  • Antiemetics
  • Anesthesiology