阿瑞匹坦和福沙匹坦的临床应用区别

Fosaprepitant and aprepitant are both neurokinin I receptor antagonists (NKIRA), which control nausea and vomiting by interacting with central nervous system substances. Aprepitant is an oral preparation and is currently on the market. Research by HU Z and others found that the CR rate of combining aprepitant with the 5-HT3 receptor antagonist and dexamethasone in controlling delayed vomiting was 74%. Fosaprepitant intravenous preparation is converted into therapeutic effect in vivo. Fosaprepitant has just been launched in China and there are very few reports. So, what is the difference in the clinical application of aprepitant and fosaprepitant?

Fosaprepitant and aprepitant are both centrally located antiemetics that can powerfully block the binding of substance P to NK-1 receptors and have shown excellent effects in the control of delayed vomiting. Fosaprepitant has a fast onset, high bioavailability, and better antiemetic effect. The guideline also mentions its vomiting intervention effect after the use of moderate and severe emetogenic drugs; aprepitant is an oral preparation and may be more convenient to use. The two drugs have their own advantages in central antiemetics.

Clinical observations on fosaprepitant combined with 5-HT3 receptor antagonists (tropisetron or granisetron) to prevent chemotherapy-related vomiting showed that the CR rate of fosaprepitant combined with tropisetron or granisetron for acute vomiting was 76.7%, the effective control rate was 90%, the control rate for delayed vomiting was 70%, and the effective control rate was 86.7% , similar to the research results on aprepitant, indicating that the efficacy of fosaprepitant is similar to that of aprepitant, especially the control effect on delayed antiemetics is better. Since patients undergoing chemotherapy often have gastrointestinal symptoms and cannot take oral medications, fosaprepitant does not need to be taken orally, and is especially suitable for the treatment of patients with gastrointestinal tumors. In terms of adverse reactions, there was no statistically significant difference between the observation group and the control group.

Note: The above information comes from the Internet and is compiled and edited by Medical Companion Travel (please correct me if there are any errors or omissions). It is only to provide information on the latest drugs on the market in the world and help Chinese patients understand the latest international new drug trends. It is only for internal discussion among medical staff and does not serve as any basis for medication. For specific medication guidelines, please consult the attending physician.