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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

The ISR monitoring of patients who experienced ISR during or after the observation period. After the observation period, we monitored the occurrence of ISR in patients who experienced ISR during the observation period. Patients who experienced ISR from fosaprepitant injection did not develop ISR again when they received subsequent chemotherapy with peroral administration of aprepitant. Gray panels indicate patients who experienced ISR; and white, patient had no ISRs. fAPR, fosaprepitant; APR, aprepitant; PV, peripheral vein; CV, central venous; and ISR, injection site reaction.
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Figure 4: The ISR monitoring of patients who experienced ISR during or after the observation period. After the observation period, we monitored the occurrence of ISR in patients who experienced ISR during the observation period. Patients who experienced ISR from fosaprepitant injection did not develop ISR again when they received subsequent chemotherapy with peroral administration of aprepitant. Gray panels indicate patients who experienced ISR; and white, patient had no ISRs. fAPR, fosaprepitant; APR, aprepitant; PV, peripheral vein; CV, central venous; and ISR, injection site reaction.

Mentions: After the investigation period (November 2011 to April 2012), we monitored patient records for the occurrence of ISR in those who had experienced ISR during the investigation period (Figure 4). In the control group, ISRs occurred in 5 patients during the observation period, and none of the ISRs resulted in discontinuation of chemotherapy. After the investigation period, 3 of 5 patients did not require further administration because their prescribed treatments were completed. The other 2 patients who continued chemotherapy with aprepitant orally experienced no ISRs even when chemotherapy was continued.


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)

The ISR monitoring of patients who experienced ISR during or after the observation period. After the observation period, we monitored the occurrence of ISR in patients who experienced ISR during the observation period. Patients who experienced ISR from fosaprepitant injection did not develop ISR again when they received subsequent chemotherapy with peroral administration of aprepitant. Gray panels indicate patients who experienced ISR; and white, patient had no ISRs. fAPR, fosaprepitant; APR, aprepitant; PV, peripheral vein; CV, central venous; and ISR, injection site reaction.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 4: The ISR monitoring of patients who experienced ISR during or after the observation period. After the observation period, we monitored the occurrence of ISR in patients who experienced ISR during the observation period. Patients who experienced ISR from fosaprepitant injection did not develop ISR again when they received subsequent chemotherapy with peroral administration of aprepitant. Gray panels indicate patients who experienced ISR; and white, patient had no ISRs. fAPR, fosaprepitant; APR, aprepitant; PV, peripheral vein; CV, central venous; and ISR, injection site reaction.
Mentions: After the investigation period (November 2011 to April 2012), we monitored patient records for the occurrence of ISR in those who had experienced ISR during the investigation period (Figure 4). In the control group, ISRs occurred in 5 patients during the observation period, and none of the ISRs resulted in discontinuation of chemotherapy. After the investigation period, 3 of 5 patients did not require further administration because their prescribed treatments were completed. The other 2 patients who continued chemotherapy with aprepitant orally experienced no ISRs even when chemotherapy was continued.

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