Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly or Moderately Emetogenic Chemotherapy: A Randomized, Double-Blind, Placebo-Controlled Study

• Published in: Journal of pain and symptom management 2014-03, Vol.47 (3), p.542-550
• Main Authors: Mizukami, Naomi, MD, Yamauchi, Masanori, MD, PhD, Koike, Kazuhiko, MD, PhD, Watanabe, Akihiko, MD, PhD, Ichihara, Koji, MD, Masumori, Naoya, MD, PhD, Yamakage, Michiaki, MD, PhD
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Aged; Anesthesia & Perioperative Care; Antiemetics - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; appetite improvement; Benzodiazepines - administration & dosage; Biological and medical sciences; chemotherapy-induced nausea and vomiting; delayed emesis; Double-Blind Method; Eating - drug effects; Female; FLI-E; Humans; Male; Medical sciences; Middle Aged; Nausea - chemically induced; Nausea - drug therapy; Neurokinin-1 Receptor Antagonists - adverse effects; Neurokinin-1 Receptor Antagonists - therapeutic use; Olanzapine; Pain Medicine; Pharmacology. Drug treatments; Psychotropic Drugs - administration & dosage; Quality of Life; Serotonin 5-HT3 Receptor Antagonists - adverse effects; Serotonin 5-HT3 Receptor Antagonists - therapeutic use; Steroids - adverse effects; Steroids - therapeutic use; Treatment Outcome; Vomiting - chemically induced; Vomiting - drug therapy; Young Adult
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2013.05.003

Abstract Context Chemotherapy-induced nausea and vomiting (CINV) can severely impair patients' quality of life (QOL). Psychotropics, especially olanzapine, have a strong antiemetic effect. Objectives To determine whether olanzapine could reduce the frequency of CINV and improve patients' QOL during chemotherapy. Methods This was a randomized, double-blind, placebo-controlled trial. Forty-four patients scheduled to receive highly or moderately emetogenic chemotherapy were enrolled. All patients received a 5-hydroxytryptamine3 receptor antagonist, steroid, and neurokinin-1 receptor antagonist. Patients were randomly assigned to take 5 mg/day of oral olanzapine (OL group, n  = 22) or placebo (control group, n  = 22) daily from the day before chemotherapy (Day 0) to Day 5. The primary endpoint was the rate of patients who achieved total control (no vomiting, no use of rescue medications, and maximum nausea of