阿瑞匹坦止吐效果好吗？

Aprepitant capsule (trade name: Yimei) is a dose-dependent CYP3A4 inhibitor. Clinically, Aprepitant capsule is administered in combination with other antiemetic drugs. It is suitable for preventing acute and delayed nausea and vomiting during the initial and repeated treatment of highly emetogenic anti-tumor chemotherapy. So is the antiemetic effect good?

Clinical studies have proven that aprepitant is effective in antiemetics. Two randomized controlled clinical studies compared the preventive effect of CINV in patients receiving highly emetogenic chemotherapy (HEC, cisplatin ≥70 mg/m2) with a standard antiemetic regimen (ondansetron + dexamethasone) ± aprepitant. The results showed that the combined aprepitant group had significantly better CR (68% vs. 48%, P<0.001) and no vomiting rate (72% vs. 50%, P<0.01) for acute and delayed CINV caused by HEC than the standard antiemetic group. A high-dose cisplatin (≥70 mg/m2) study conducted by Chinese scholars in 2011 also obtained similar results. The CR (69% vs. 57%, P=0.007) and vomiting-free rate (71% vs. 57%, P=0.003) of aprepitant + standard antiemetic regimen (granisetron + dexamethasone) for CINV were significantly higher than those of the standard antiemetic group (Figure 1). In women with breast cancer treated with AC regimen, aprepitant combined with standard antiemetic regimen was also superior in CR (P=0.015) and vomiting-free rate (P<0.001) in preventing CINV.

It is a selective high-affinity antagonist of the human substance P neurokinin 1 (NK1) receptor. Other existing drugs for the treatment of chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV) have low or no affinity for the targets 5-hydroxytryptamine receptor 3 (5-HT3), dopamine receptors and glucocorticoid receptors. Studies have shown that NK1 receptor antagonists can inhibit the acute and delayed phase vomiting caused by cytotoxic chemotherapy drugs, such as cisplatin, and enhance the antiemetic activity of the 5-HT3 receptor antagonist ondansetron and the glucocorticoid dexamethasone against cisplatin-induced vomiting.

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.