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Highly frequent and enhanced injection site reaction induced by peripheral venous injection of fosaprepitant in anthracycline-treated patients.

Sato Y, Kondo M, Inagaki A, Komatsu H, Okada C, Naruse K, Sahashi T, Kuroda J, Ogura H, Uegaki S, Yoshida T, Mori Y, Sawada H, Watanabe S, Sugiura H, Endo Y, Yoshimoto N, Toyama T, Iida S, Yamada K, Kimura K, Wakita A - J Cancer (2014)

Bottom Line: We conducted this retrospective study to clarify the incidence and symptoms of fosaprepitant-associated ISR in patients treated with anthracycline.By multivariate analysis, fosaprepitant injection was found to be a significant independent variable correlated with ISR risk.ISR occurred more frequently and severely when fosaprepitant was injected through the peripheral vein in patients treated with anthracyclines compared to those without fosaprepitant.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Pharmacy, Nagoya City West Medical Center.

ABSTRACT

Background: Fosaprepitant-associated injection site reaction (ISR) has been reported in patients treated with cisplatin, an irritant drug. We conducted this retrospective study to clarify the incidence and symptoms of fosaprepitant-associated ISR in patients treated with anthracycline.

Patients and methods: Fifty six patients receiving 159 injections administering doxorubicin/cyclophosphamide (AC), fluorouracil/epirubicin/cyclophosphamide (FEC), or rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone (R-)CHOP regimen through a peripheral vein at ambulatory treatment centers reviewed for this study from patients' medical records. Incidence of ISR was compared between 24 patients with fosaprepitant injection (fosaprepitant group) and 32 patients without fosaprepitant (control group). Frequency and symptoms of ISR per injection were also compared between 61 injections with fosaprepitant and 98 injections without fosaprepitant.

Results: Both the ISR incidence rate per patient and per injection were significantly higher in the fosaprepitant group than in the control group (67% vs. 16%; P=0.0002, 34% vs. 8.2%; P<0.0001, respectively). By multivariate analysis, fosaprepitant injection was found to be a significant independent variable correlated with ISR risk. Symptoms observed in 61 injections of fosaprepitant were pain (n=14, 23%), erythema (n=10, 16%), swelling (n=6, 10%), and delayed drip infusion (n=6, 10%). After the observation period, no ISR occurred when the administration route was changed to central venous injection or oral aprepitant was administered despite the continuation of chemotherapy.

Conclusion: ISR occurred more frequently and severely when fosaprepitant was injected through the peripheral vein in patients treated with anthracyclines compared to those without fosaprepitant.

No MeSH data available.


Related in: MedlinePlus

Clinical symptoms (A) and managements of ISR (B). The frequency of (A) clinical symptoms and (B) managements of ISR was assessed for 61 injections in the fosaprepitant group and 98 injections in the control group. Black bars represent the frequency of symptoms or managements together with treatment-required ISR, and gray bars represent the frequency of clinical symptoms or managements together with non-treatment required ISR. * depicts the phenomenon observed without the handle of clinical staffs. ISR, injection site reaction; and fAPR, fosaprepitant.
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Figure 3: Clinical symptoms (A) and managements of ISR (B). The frequency of (A) clinical symptoms and (B) managements of ISR was assessed for 61 injections in the fosaprepitant group and 98 injections in the control group. Black bars represent the frequency of symptoms or managements together with treatment-required ISR, and gray bars represent the frequency of clinical symptoms or managements together with non-treatment required ISR. * depicts the phenomenon observed without the handle of clinical staffs. ISR, injection site reaction; and fAPR, fosaprepitant.

Mentions: The frequency per injection of clinical symptoms and managements of ISR observed in this study are shown in Figure 3. These items in 61 injections in the fosaprepitant group included pain (14 injections, 23%), erythema (10 injections, 16%), swelling (6 injections, 10%), delayed drip infusion (the phenomenon observed without the handle of clinical stuffs) (6 injections, 10%), re-puncture (13 injections, 21%), dermatological treatment (12 injections, 20%), and discontinuation of the injection (2 injections, 3%). In contrast, of 98 injections in the control group, they included pain (6 injections, 6%), erythema (1 injection, 1%), delayed drip infusion (1 injection, 1%), and re-puncture (1 injection, 1%). Dermatological treatment and discontinuation of the injection were not required in any of the cases in the control group.


Highly frequent and enhanced injection site reaction induced by peripheral venous injection of fosaprepitant in anthracycline-treated patients.

Sato Y, Kondo M, Inagaki A, Komatsu H, Okada C, Naruse K, Sahashi T, Kuroda J, Ogura H, Uegaki S, Yoshida T, Mori Y, Sawada H, Watanabe S, Sugiura H, Endo Y, Yoshimoto N, Toyama T, Iida S, Yamada K, Kimura K, Wakita A - J Cancer (2014)

Clinical symptoms (A) and managements of ISR (B). The frequency of (A) clinical symptoms and (B) managements of ISR was assessed for 61 injections in the fosaprepitant group and 98 injections in the control group. Black bars represent the frequency of symptoms or managements together with treatment-required ISR, and gray bars represent the frequency of clinical symptoms or managements together with non-treatment required ISR. * depicts the phenomenon observed without the handle of clinical staffs. ISR, injection site reaction; and fAPR, fosaprepitant.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4007527&req=5

Figure 3: Clinical symptoms (A) and managements of ISR (B). The frequency of (A) clinical symptoms and (B) managements of ISR was assessed for 61 injections in the fosaprepitant group and 98 injections in the control group. Black bars represent the frequency of symptoms or managements together with treatment-required ISR, and gray bars represent the frequency of clinical symptoms or managements together with non-treatment required ISR. * depicts the phenomenon observed without the handle of clinical staffs. ISR, injection site reaction; and fAPR, fosaprepitant.
Mentions: The frequency per injection of clinical symptoms and managements of ISR observed in this study are shown in Figure 3. These items in 61 injections in the fosaprepitant group included pain (14 injections, 23%), erythema (10 injections, 16%), swelling (6 injections, 10%), delayed drip infusion (the phenomenon observed without the handle of clinical stuffs) (6 injections, 10%), re-puncture (13 injections, 21%), dermatological treatment (12 injections, 20%), and discontinuation of the injection (2 injections, 3%). In contrast, of 98 injections in the control group, they included pain (6 injections, 6%), erythema (1 injection, 1%), delayed drip infusion (1 injection, 1%), and re-puncture (1 injection, 1%). Dermatological treatment and discontinuation of the injection were not required in any of the cases in the control group.

Bottom Line: We conducted this retrospective study to clarify the incidence and symptoms of fosaprepitant-associated ISR in patients treated with anthracycline.By multivariate analysis, fosaprepitant injection was found to be a significant independent variable correlated with ISR risk.ISR occurred more frequently and severely when fosaprepitant was injected through the peripheral vein in patients treated with anthracyclines compared to those without fosaprepitant.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Pharmacy, Nagoya City West Medical Center.

ABSTRACT

Background: Fosaprepitant-associated injection site reaction (ISR) has been reported in patients treated with cisplatin, an irritant drug. We conducted this retrospective study to clarify the incidence and symptoms of fosaprepitant-associated ISR in patients treated with anthracycline.

Patients and methods: Fifty six patients receiving 159 injections administering doxorubicin/cyclophosphamide (AC), fluorouracil/epirubicin/cyclophosphamide (FEC), or rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone (R-)CHOP regimen through a peripheral vein at ambulatory treatment centers reviewed for this study from patients' medical records. Incidence of ISR was compared between 24 patients with fosaprepitant injection (fosaprepitant group) and 32 patients without fosaprepitant (control group). Frequency and symptoms of ISR per injection were also compared between 61 injections with fosaprepitant and 98 injections without fosaprepitant.

Results: Both the ISR incidence rate per patient and per injection were significantly higher in the fosaprepitant group than in the control group (67% vs. 16%; P=0.0002, 34% vs. 8.2%; P<0.0001, respectively). By multivariate analysis, fosaprepitant injection was found to be a significant independent variable correlated with ISR risk. Symptoms observed in 61 injections of fosaprepitant were pain (n=14, 23%), erythema (n=10, 16%), swelling (n=6, 10%), and delayed drip infusion (n=6, 10%). After the observation period, no ISR occurred when the administration route was changed to central venous injection or oral aprepitant was administered despite the continuation of chemotherapy.

Conclusion: ISR occurred more frequently and severely when fosaprepitant was injected through the peripheral vein in patients treated with anthracyclines compared to those without fosaprepitant.

No MeSH data available.


Related in: MedlinePlus