Estudo de fase II de pregabalina para prevenção de náuseas e vômitos induzidos por quimioterapia

Autores

DOI:

https://doi.org/10.15343/0104-7809.202448e15402023P

Palavras-chave:

Náuseas, Antagonistas do receptor da Neurocinina-1, Pregabalina, Antieméticos, Câncer

Resumo

Para avaliar o papel da pregabalina na proteção das náuseas e vômitos induzidos pela quimioterapia, foi realizado um ensaio clínico de fase II, aleatorizado, duplamente cego, controlado por placebo, para investigar se a pregabalina poderia melhorar o controle completo das náuseas e vômitos (desfecho primário). Inscrevemos 82 pacientes virgens de quimioterapia, programados para receber quimioterapia moderadamente e altamente emetogênica. Todos os doentes receberam ondansetron 8mg por via intravenosa, dexametasona 10mg antes da quimioterapia no primeiro dia e, dexametasona 4 mg por via oral, b.d., nos dias dois e três. Os doentes foram distribuídos aleatoriamente para tomar pregabalina 75 mg ou placebo, bd, desde a noite anterior à quimioterapia até ao quinto dia. A resposta completa global não foi estatisticamente significativa entre os grupos (53,7 versus 48,8%, respetivamente, no grupo da pregabalina e no grupo de controlo (P=0,65)). Também não houve diferença estatística significativa durante a fase aguda (primeiras 24 horas) e a fase tardia (24-120h): 80,5% versus 82,9% (P=0,77), 53,7 versus 51,2% (P=0,82), respectivamente. Neste estudo não foi identificada ação da pregabalina na prevenção de náuseas e vômitos induzidos por quimioterapia. Número de registo no Clinicaltrial.gov: NCT04181346.

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Referências

Chan VT, Yeo W. Antiemetic therapy options for chemotherapy-induced nausea and vomiting in breast cancer patients. Breast Cancer (Dove Med Press). 2011; 3: 151-60.

Lorusso D, Bria E, Costantini A, Di Maio M, Rosti G, Mancuso A. Patients' perception of chemotherapy side effects: Expectations, doctor-patient communication and impact on quality of life - An Italian survey. Eur J Cancer Care (Engl). 2017; 26(2): e12618.

Sommariva S, Pongiglione B, Tarricone R. Impact of chemotherapy-induced nausea and vomiting on health-related quality of life and resource utilization: A systematic review. Crit Rev Oncol Hematol. 2016; 99: 13-36.

Grunberg SM. Antiemetic activity of corticosteroids in patients receiving cancer chemotherapy: dosing, efficacy, and tolerability analysis. Ann Oncol. 2007; 18(2): 233-40.

Roila F, Ruggeri B, Ballatori E, Del Favero A, Tonato M. Aprepitant versus dexamethasone for preventing chemotherapy-induced delayed emesis in patients with breast cancer: a randomized double-blind study. J Clin Oncol. 2014;32(2):101-6.

del Giglio A, Soares HP, Caparroz C, Castro PC. Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting: results of a meta-analysis of randomized controlled trials. Cancer. 2000; 89(11): 2301-8.

Takahashi T, et al. A prospective study of palonosetron for prevention of chemotherapy-induced nausea and vomiting in malignant lymphoma patients following highly emetogenic chemotherapy. Int J Clin Oncol. 2018; 23(1): 189-94.

Yokoe T, et al. Effectiveness of antiemetic regimens for highly emetogenic chemotherapy-induced nausea and vomiting: a systematic review and network meta-analysis. Oncologist. 2019; 24(6): e347-57.

Suzuki K, et al. Randomized, double-blind, phase III trial of palonosetron versus granisetron in the triplet regimen for preventing chemotherapy-induced nausea and vomiting after highly emetogenic chemotherapy: TRIPLE study. Ann Oncol. 2016; 27(8): 1601-6.

Navari RM, Rapoport BL, Powers D, Arora S, Clark-Snow R. Rolapitant for the prevention of nausea in patients receiving highly or moderately emetogenic chemotherapy. Cancer Med. 2018; 7(7): 2943-50.

Yuan DM, et al. Efficacy and safety of neurokinin-1 receptor antagonists for prevention of chemotherapy-induced nausea and vomiting: systematic review and meta-analysis of randomized controlled trials. Asian Pac J Cancer Prev. 2016; 17(4): 1661-75. Review.

Zhang Y, et al. Optimal prophylaxis of chemotherapy-induced nausea and vomiting for moderately emetogenic chemotherapy: a meta-analysis. Future Oncol. 2018; 14(19): 1933-41.

Clemmons AB, Orr J, Andrick B, Gandhi A, Sportes C, DeRemer D. Randomized, placebo-controlled, phase III trial of fosaprepitant, ondansetron, dexamethasone (FOND) versus FOND plus olanzapine (FOND-O) for the prevention of chemotherapy-induced nausea and vomiting in patients with hematologic malignancies receiving highly emetogenic chemotherapy and hematopoietic cell transplantation regimens: the FOND-O trial. Biol Blood Marrow Transplant. 2018; 24(10): 2065-71.

Iihara H, et al. Clinical trial protocol of doublet therapy and olanzapine for carboplatin-induced nausea and vomiting in patients with thoracic cancer: a multicentre phase II trial. BMJ Open. 2019; 9(7): e028056.

Navari RM. Olanzapine for the prevention and treatment of chronic nausea and chemotherapy-induced nausea and vomiting. Eur J Pharmacol. 2014; 722: 180-6. Review.

Tienchaiananda P, et al. A randomized, double-blind, placebo-controlled study evaluating the efficacy of combination olanzapine, ondansetron and dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients receiving doxorubicin plus cyclophosphamide. Ann Palliat Med. 2019; 8(4): 372-80.

Navari RM, et al. Olanzapine for the prevention of chemotherapy-induced nausea and vomiting. N Engl J Med. 2016; 375(2): 134- 42.

Bymaster FP, et al. Radioreceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology. 1996; 14(2): 87-96.

Berger MJ, et al. NCCN guidelines insights: antiemesis, version 2.2017. J Natl Compr Canc Netw. 2017; 15(7): 883-93.

Hesketh PJ, Bohlke K, Kris MG. Antiemetics: American Society of Clinical Oncology clinical practice guideline update summary. J Oncol Pract. 2017; 13(12): 825-30.

Razvi Y, et al. ASCO, NCCN, MASCC/ESMO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in adult patients. Support Care Cancer. 2019; 27(1): 87-95. Review.

Calandre EP, Rico-Villademoros F, Slim M. Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use. Expert Rev Neurother. 2016;16(11):1263-77. Review. Erratum in: Expert Rev Neurother. 2016; 16(11): iii.

Gajraj NM. Pregabalin: its pharmacology and use in pain management. Anesth Analg. 2007;105(6):1805-15. Review. Erratum in: Anesth Analg. 2008; 106(5): 1584.

Li F, et al. The efficacy of pregabalin for the management of postoperative pain in primary total knee and hip arthroplasty: a meta analysis. J Orthop Surg Res. 2017; 12(1): 49.

Wang YM, et al. Pregabalin can decrease acute pain and postoperative nausea and vomiting in hysterectomy: A meta-analysis. Medicine (Baltimore). 2017; 96(31): e7714. Review.

Grunberg SM, et al. Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity -- state of the art. Support Care Cancer. 2011;19 Suppl 1: S43-7. Review.

Decker GM, DeMeyer ES, Kisko DL. Measuring the maintenance of daily life activities using the functional living index-emesis (FLIE) in patients receiving moderately emetogenic chemotherapy. J Support Oncol. 2006; 4(1): 35-41.

Fink K, Dooley DJ, Meder WP, Suman-Chauhan N, Duffy S, Clusmann H, et al. Inhibition of neuronal Ca(2+) influx by gabapentin and pregabalin in the human neocortex. Neuropharmacology. 2002;42:229–36.

Field MJ, Cox PJ, Stott E, Melrose H, Offord J, Su TZ, et al. Identification of the alpha2-delta-1 subunit of voltage-dependent calcium channels as a molecular target for pain mediating the analgesic actions of pregabalin. Proc Natl Acad Sci. 2006;103:17537–42.

Guttuso T Jr, Roscoe J, Griggs J. Effect of gabapentin on nausea induced by chemotherapy in patients with breast cancer. Lancet. 2003; 361(9370): 1703-5.

Cruz FM, et al. Gabapentin for the prevention of chemotherapy- induced nausea and vomiting: a pilot study. Support Care Cancer. 2012; 20(3): 601-6.

Barton DL, Thanarajasingam G, Sloan JA, Diekmann B, Fuloria J, Kottschade LA, Lyss AP, Jaslowski AJ, Mazurczak MA, Blair SC, Terstriep S, Loprinzi CL. Phase III double-blind, placebo-controlled study of gabapentin for the prevention of delayed chemotherapy induced nausea and vomiting in patients receiving highly emetogenic chemotherapy, NCCTG N08C3 (Alliance). Cancer. 2014 Nov 15;120(22):3575-83. doi: 10.1002/cncr.28892.

Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet. 2010 Oct;49(10):661-9. doi: 10.2165/11536200-000000000-00000.

Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet. 2010; 49(10): 661-9.

Zhang J, Ho KY, Wang Y. Efficacy of pregabalin in acute postoperative pain: a meta-analysis. Br J Anaesth. 2011 Apr;106(4):454-62. doi: 10.1093/bja/aer027.

Grant, M. C., Betz, M., Hulse, M., Zorrilla-Vaca, A., Hobson, D., Wick, E., & Wu, C. L. (2016). The Effect of Preoperative Pregabalin on Postoperative Nausea and Vomiting: A Meta-analysis. Anesthesia and analgesia, 123(5), 1100-1107. https://doi.org/10.1213/ ANE.0000000000001404

Publicado

2024-03-11

Como Citar

Paniquar, C. S. R., del Giglio, A., Yamada, A. M. T. D., & Melo Cruz, F. J. S. (2024). Estudo de fase II de pregabalina para prevenção de náuseas e vômitos induzidos por quimioterapia. O Mundo Da Saúde, 48. https://doi.org/10.15343/0104-7809.202448e15402023P

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