1) EMENDâ„¢ is a new NK1 receptor antagonist approved for preventing acute and delayed nausea and vomiting due to highly and moderately emetogenic chemotherapy.
2) It works by blocking the neurokinin-1 receptor pathway in the brain and should be used in combination with a 5-HT3 receptor antagonist and dexamethasone.
3) Clinical trials showed that combining EMENDâ„¢ with a 5-HT3 receptor antagonist and dexamethasone helped significantly more patients receiving cisplatin chemotherapy to remain vomit-free over 5 days compared to a regimen with just a 5-HT3 receptor antagonist and dexamethasone.
Dapagliflozin is an AstraZeneca patented medication. In India, Sun Pharma and Abbott serve as licensed partners for dapagliflozin's distribution. While the primary patent for dapagliflozin expired in October 2020, a specific (species) patent safeguards AstraZeneca's dapagliflozin in India until May 15, 2023.
Under the brand name "Oxra®," Sun Pharma will undertake the promotion and distribution of dapagliflozin. This medication is approved for use in the United States as a monotherapy and in combination therapy to enhance glycemic control in patients with type 2 diabetes.
In China, the National Medical Products Administration (NMPA) approved dapagliflozin, both in combination with metformin and as a standalone treatment, for inadequately-controlled type-2 diabetes mellitus. It was introduced for the treatment of type 2 diabetes in China in 2018.
Japan has authorized Forxiga (dapagliflozin) as an oral adjunct treatment to insulin for adults with type-1 diabetes (T1D).
The Shanghai Shenkang Hospital Development Center has outlined a three-year plan to promote clinical skills and innovations in municipal hospitals, reflecting a commitment to healthcare advancements.
Efforts are being made to expand distribution channels across diverse geographical regions. AstraZeneca is closely monitoring the Indian market to secure a significant share and prevent the infringement of dapagliflozin by generic manufacturers.
Regulatory bodies are actively assessing dapagliflozin's drug and approval processes, ensuring compliance with appropriate dose and indication guidelines. For further inquiries, please contact pranayraju66@gmail.com.
1. A Case report of Heart Failure
2. Discussion on Heart Failure
3. Role of Peptides in Heart Failure
4. Importance of 30 days in heart failure
5. Role of ENTRESTO in Stable Heart Failure patient (PARADIGM-HF study)(HFrEF)
6. Biomarkers in Heart Failure
7. Role of ARNI in Hospitalized Heart Failure patient (PIONEER-HF study)
8. Role of ARNI in HFpEF (PARAMOUNT Trial)
9. Safety and usefulness of ACEI/ARB/ARNI
10. Role of SGPL2 inhibitors in HF with/without DM
Dapagliflozin is an AstraZeneca patented medication. In India, Sun Pharma and Abbott serve as licensed partners for dapagliflozin's distribution. While the primary patent for dapagliflozin expired in October 2020, a specific (species) patent safeguards AstraZeneca's dapagliflozin in India until May 15, 2023.
Under the brand name "Oxra®," Sun Pharma will undertake the promotion and distribution of dapagliflozin. This medication is approved for use in the United States as a monotherapy and in combination therapy to enhance glycemic control in patients with type 2 diabetes.
In China, the National Medical Products Administration (NMPA) approved dapagliflozin, both in combination with metformin and as a standalone treatment, for inadequately-controlled type-2 diabetes mellitus. It was introduced for the treatment of type 2 diabetes in China in 2018.
Japan has authorized Forxiga (dapagliflozin) as an oral adjunct treatment to insulin for adults with type-1 diabetes (T1D).
The Shanghai Shenkang Hospital Development Center has outlined a three-year plan to promote clinical skills and innovations in municipal hospitals, reflecting a commitment to healthcare advancements.
Efforts are being made to expand distribution channels across diverse geographical regions. AstraZeneca is closely monitoring the Indian market to secure a significant share and prevent the infringement of dapagliflozin by generic manufacturers.
Regulatory bodies are actively assessing dapagliflozin's drug and approval processes, ensuring compliance with appropriate dose and indication guidelines. For further inquiries, please contact pranayraju66@gmail.com.
1. A Case report of Heart Failure
2. Discussion on Heart Failure
3. Role of Peptides in Heart Failure
4. Importance of 30 days in heart failure
5. Role of ENTRESTO in Stable Heart Failure patient (PARADIGM-HF study)(HFrEF)
6. Biomarkers in Heart Failure
7. Role of ARNI in Hospitalized Heart Failure patient (PIONEER-HF study)
8. Role of ARNI in HFpEF (PARAMOUNT Trial)
9. Safety and usefulness of ACEI/ARB/ARNI
10. Role of SGPL2 inhibitors in HF with/without DM
#flozins
🫀DAPA 🆚placebo in HFpEF
Now we have a positive trial!
⬇️18% in CV☠️ death or
worsening HF among LVEF>40%
⬇️ 21%heart failure
💥Results same for LVEF> 60% 🆚LVEF<60%
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
On DPP-Inhibitor ,case study on Linagliptin,Safe and affective class of drug for Management of Type II Diabetes as Monotherapy and add on therapy with OHA and Insulin,It can be added to SGLT2 Inhibitor also.
Beta Blockers in current cardiovascular practice Praveen Nagula
betablockers are the drug of choice for prevention of progression of heart failure with mortality benefit, after the evolution of neurohormonal regulation as pathogenesis of heart failure
#flozins
🫀DAPA 🆚placebo in HFpEF
Now we have a positive trial!
⬇️18% in CV☠️ death or
worsening HF among LVEF>40%
⬇️ 21%heart failure
💥Results same for LVEF> 60% 🆚LVEF<60%
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
On DPP-Inhibitor ,case study on Linagliptin,Safe and affective class of drug for Management of Type II Diabetes as Monotherapy and add on therapy with OHA and Insulin,It can be added to SGLT2 Inhibitor also.
Beta Blockers in current cardiovascular practice Praveen Nagula
betablockers are the drug of choice for prevention of progression of heart failure with mortality benefit, after the evolution of neurohormonal regulation as pathogenesis of heart failure
Rhematoid Arthritis_CME symposium program abstracts and introduction written ...ckaczk
Abstracts and intro written having been given only the titles of the abstracts. I did all the literature reviews/research to write and reference the abstracts for these rheumatologists (key opinion leaders) for this Mexican meeting. I also attended the meeting and subsequently wrote a report.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Emend Detail Aid Poster Work Sample Crystal Kaczkowski Watermarked
1. DRAFT COPY
Introducing EMEND™ (aprepitant)
The First Neurokinin-1 (NK1) Receptor Antagonist
For patients receiving highly emetogenic chemotherapy
and women receiving anthracycline and
cyclophosphamide-based chemotherapy
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From the Start.
Combination therapy with EMEND ™
helps prevent CINV—from Cycle 1, Day 1.
DRug INTERAcTIoNS
INDIcATIoNS or back-up methods of contraception should be used during
treatment with EMEND™ and for 1 month following the last
Serious Drug Interactions
EMEND™ (aprepitant), in combination with a 5-HT3 antagonist
dose of EMEND™.
class of antiemetics and dexamethasone, is indicated for the: • EMEND™ should be used with caution in patients receiving
ADVERSE REAcTIoNS
concomitant medicinal products that are primarily metabolized
1. prevention of acute and delayed nausea and vomiting due to
through CYP3A4 and CYP2C9, including chemotherapy agents.
highly emetogenic cancer chemotherapy Clinical Trial Adverse Experiences
Inhibition of CYP3A4 by aprepitant could result The most common adverse experiences, regardless of causality,
2. prevention of nausea and vomiting in women due to treatment
in elevated plasma concentrations of these concomitant occurring in patients receiving highly emetogenic chemotherapy
with moderately emetogenic cancer chemotherapy consisting of
medicinal products. Induction of CYP2C9 by aprepitant could who were treated with aprepitant in clinical studies (cycle 1)
cyclophosphamide and anthracycline
result in decreased plasma were: asthenia/ fatigue (17.8%), nausea (12.7%), hiccups
concentrations of these concomitant medicinal products.
coNTRAINDIcATIoNS (10.8%), diarrhea (10.3%), constipation (10.3%), anorexia
(10.1%). The most common adverse experiences, regardless of
• The effect of EMEND™ on the pharmacokinetics of orally
EMEND™ is contraindicated in patients who are hypersensitive to
causality, occurring in patients receiving moderately emetogenic
any component of the formulation. EMEND™ should not be used administered CYP3A4 substrates is greater than the effect
chemotherapy who were treated with aprepitant in clinical studies
of EMEND™ on the pharmacokinetics of intravenously
concurrently with pimozide, terfenadine, astemizole, or cisapride.
(cycle 1) were: alopecia (24.0%), fatigue (21.9%), headache
administered CYP3A4 substrates.
Inhibition of cytochrome P450 isoenzyme 3A4 (CYP3A4) by
(16.4%), constipation (12.3%), neutropenia (8.9%).
aprepitant could result in elevated plasma concentrations of these • The efficacy of hormonal contraceptives during and for 28 days
drugs, potentially causing serious or life-threatening reactions. after administration of EMEND™ may be reduced. Alternative
Reference:
1. Data on file, Merck Frosst Canada Ltd.: EMEND™ — Product Monograph, 2007.
CINV = chemotherapy-induced nausea and vomiting
EMEND™ is a Trademark of Merck & Co., Inc. Used under license.
2. DRAFT COPY
5-HT3 receptor antagonists may not be enough
How Many of Your Patients
Treated With a 5-HT3 Receptor
Antagonist Still Experience
chemotherapy-induced Nausea
and Vomiting?
CINV Remains a Critical Problem
Observed Incidence of Nausea and Vomiting in Patients
Receiving Highly Emetogenic Chemotherapy (Cycle 1)
33%
Nausea
Acute
Day 1
12%
Vomiting
60%
Nausea
Delayed
Day 2–5
50%
Vomiting
0 10 20 30 40 50 60 70
% of patients with nausea or vomiting (N=67)
• Up to 60% of patients treated with antiemetics continued to
experience nausea and vomiting
Observed Incidence of Nausea and Vomiting in Patients
Receiving Moderately Emetogenic Chemotherapy (Cycle 1)
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52%
Nausea
Delayed
Day 2–5
28%
Vomiting
0 10 20 30 40 50 60 70
% of patients with nausea or vomiting (N=231)
• Up to 52% of patients treated with antiemetics continued to
experience nausea and vomiting
Study Design and Results
In this multinational, prospective, observational study, physicians/nurses (N=13/11) estimated the frequency of acute (Day 1) and delayed (Days 2-5) nausea
and vomiting after first administration of highly or moderately emetogenic chemotherapy and antiemetic treatment. Chemotherapy-naive patients older than
18 years (N=298) received either single-agent or combination therapy: highly emetogenic chemotherapy, such as cisplatin >50 mg/m2 or cyclophosphamide
>1500 mg/m2, or moderately emetogenic chemotherapy, such as doxorubicin >20 mg/m2 or cyclophosphamide <1500 mg/m2. Patients recorded emetic
episodes, nausea assessments, and antiemetic medications taken daily in a 6-day diary, which was then evaluated and matched against the medical
predictions. Most patients (97%) received 5-HT3 antagonist; 78% also received a corticosteroid (mean 2.3 antiemetic agents per patient). The most common
duration of 5-HT3 antagonist and corticosteroid therapy was 3 days.
Reference:
Grunberg SM, Deuson RR, Mavros P et al. Incidence of chemotherapy-induced nausea and vomiting
after modern antiemetics. Cancer 2004;100:2261–2268.
CINV = chemotherapy-induced nausea and vomiting
EMEND™ is a Trademark of Merck & Co., Inc. Used under license.
3. DRAFT COPY
Chemotherapy-induced nausea and vomiting
2 Key Pathways can Trigger
Emetic Response1
central Pathway
Activated by substance P
Mediated by NK1 receptors in
the emetic center of the brain
Blocked by NK1 receptor
antagonist
— EMEND™
Peripheral Pathway
Activated by serotonin
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Mediated by 5-HT3 receptors
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Blocked by 5-HT3 receptor
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antagonists
— Zofran (ondansetron) ®
— Kytril (granisetron)
®
— Anzemet ® (dolasetron)
Adapted from Grunberg et al2 and Hesketh et al.1
EMEND + 5-HT3 Receptor Antagonist
™
Target Both Pathways
Reference:
1. Hesketh PJ, Van Belle S, Aapro M, et al. Differential involvement of neurotransmitters through the time
course of cisplatin-induced emesis as revealed by therapy with specific receptor antagonists.
Eur J Cancer. 2003;39:1074–1080.
2. Grunberg SM, Hesketh PJ. Control of chemotherapy-induced emesis. N Engl J Med. 1993;329:1790–1796.
EMEND™ is a Trademark of Merck & Co., Inc. Used under license.
4. DRAFT COPY
In many patients receiving cisplatin-based chemotherapy,
EMEND™ From the Start
Helped Significantly More Patients
to Remain Free of Vomiting over
5 Days
Time to First Emesis
Day 1
Control regimen Zofran® (32 mg IV), dexamethasone
20 mg PO, and placebo Day 1
EMENDTM regimen EMENDTM 125 mg PO,
Zofran® 32 mg IV, and dexamethasone 12 mg PO Day 1
100
90
Percentage of Patients With No Vomiting
EMENDTM regimen (n=260)
80
70 p<0.001
60
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Control regimen Dexamethasone 16 mg PO and
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placebo Days 2–4
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Acute Delayed EMENDTM regimen EMENDTM 80 mg PO Days 2 and 3;
dexamethasone 8 mg PO Days 2–4
0–24 hours
Day 1 Day 2 Day 3 Day 4 Day 5
Dose 1 Dose 2 Dose 3
Days Since Initiation of Chemotherapy
Study Design and Results
In a multicenter, randomized, double-blind, placebo-controlled clinical study, combination therapy with EMENDTM was compared with a 5-HT3 receptor antagonist regimen
in 530 cisplatin-naive patients receiving a chemotherapy regimen that included cisplatin ≥70 mg/m2. Some patients also received additional chemotherapeutic agents.
The primary clinical end point was “complete response” (overall, Days 1–5), defined as no vomiting and no rescue medication for nausea or vomiting. The percentage of
patients achieving a complete response over 5 days were significantly improved with the EMEND™ regimen than the control regimen, respectively: overall phase 72.7%
vs 52.3%; acute phase 89.2% vs 78.1%; delayed phase 75.4% vs 55.8%, p<0.001). The most common drug-related adverse experiences reported in patients treated with
the aprepitant regimen and greater than control therapy were: hiccups, asthenia/fatigue and nausea occuring after day 5.
Therapy Regimen
*Combination therapy with EMENDTM=3 days EMENDTM (125 mg PO on Day 1 and 80 mg PO once daily on Days 2 and 3); plus 1 day ZOFRAN® (ondansetron) (32 mg IV
on Day 1); plus 4 days dexamethasone (12 mg PO on Day 1 and 8 mg PO once daily on Days 2–4).
**Control regimen=ZOFRAN® was administered at maximum dose of 32 mg IV on Day 1 and not followed by oral 5-HT3 therapy on Days 2-5.
Reference:
Hesketh PJ, Grunberg SM, Gralla RJ, et al; the Aprepitant Protocol 052 Study Group.
The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a
multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin-
the Aprepitant Protocol 052 Study Group. J Clin Oncol. 2003;21(22):4112-9.
EMEND™ is a Trademark of Merck & Co., Inc. Used under license.