Patel, B;
Downie, J;
Bayliss, J;
Stephenson, A;
Bluebond-Langer, M;
(2021)
Long-term daily administration of aprepitant for the management of intractable nausea and vomiting in children with life-limiting conditions: a case series.
J Pain Symptom Manage
10.1016/j.jpainsymman.2021.02.007.
(In press).
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Abstract
BACKGROUND: Nausea and vomiting is a common symptom in children through their end of life journey. Aprepitant, a NK-1 antagonist, has become a potent weapon in the fight against chemo-induced nausea and vomiting. However, its use in palliative care for refractory nausea and vomiting has been limited due to limited experience or evidence of continuous use. Emerging evidence suggests that continuous use is not only safe, but also effective in patients with nausea and vomiting refractory to multiple lines of anti-emetic therapy. METHODS: We conducted a single centre retrospective chart review of children receiving care from a specialist palliative care team who were given continuous daily aprepitant for nausea and vomiting and were unresponsive to at least 2 prior lines of anti-emetic therapy. Parental reports of the impact of nausea on mobility and feeding were used as proxy efficacy markers. Duration of effect and toxicity was also evaluated. RESULTS: 10 children (8 with cancer as a primary diagnosis and 2 with non-cancer diagnoses) received continuous aprepitant and all showed resolution of nausea and vomiting and an increased ability to mobilise and tolerate feeds. No adverse events noted. CONCLUSION: Our review suggests a role for aprepitant in management of refractory nausea and vomiting, demonstrating safety and efficacy. This case series is the first report of aprepitant use in this manner in the paediatric palliative care setting.
| Type: | Article |
|---|---|
| Title: | Long-term daily administration of aprepitant for the management of intractable nausea and vomiting in children with life-limiting conditions: a case series. |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jpainsymman.2021.02.007 |
| Publisher version: | https://doi.org/10.1016/j.jpainsymman.2021.02.007 |
| Language: | English |
| Additional information: | © 2021 The Authors. Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| Keywords: | Aprepitant, Life-limiting, Nausea, Paediatric, Vomiting, palliative |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10124800 |
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