Health
Olanzapine drugs help control nausea and vomiting in patients with advanced cancer
Olanzapine, a generic drug used to treat nerves, emotions, and mental states, also helps patients with advanced cancer to better manage nausea and vomiting unrelated to chemotherapy. These are the findings released Thursday, May 7th. JAMA Oncology.
Mayo Clinic oncologist Charles Loprinzi, M.D., played a leading role in this study in collaboration with Rudolph Navari, M.D. at the University of Alabama at Birmingham.
“Most people appreciate that patients undergoing cancer chemotherapy suffer from nausea and vomiting,” explains Loprinzi. “But it is not well understood that patients with advanced cancer have serious problems with nausea and vomiting that are unrelated to chemotherapy.”
Dr. Loprinzi and Navari have decided to conduct a clinical trial because they found a limited study of nausea and vomiting in patients with advanced cancer who were unrelated to chemotherapy.
A colleague, along with other collaborators, conducted a randomized, placebo-controlled trial in 30 patients with advanced cancer who had not recently received chemotherapy or radiation therapy but had substantial problems with nausea and vomiting. Did.
The researchers randomly assigned patients to receive low doses of olanzapine or placebo daily. Neither the study participants nor their clinicians knew if they were receiving olanzapine or placebo.
Before starting dosing on the first day of the study, participants rated nausea over the last 24 hours on a scale of 0-10. 0 is none, 10 is as bad as possible. Participants continued to assess nausea at approximately the same time each day during the study.
When the study was not blinded, the study team found that all 30 participants scored a nausea score of 8-10 on the first day of the study. After 1 day and 1 week, 15 patients receiving placebo still had nausea scores of 8-10.
In contrast, the 15 patients who received olanzapine had 2-3 points after 1 day and 0-3 points after 1 week. Similarly, these patients reported less vomiting, better appetite, and better health. No patient-reported adverse events were observed among study participants receiving olanzapine.
“Olanzapine, given at 5 milligrams daily for 7 days, significantly improved the patient’s quality of life and had no side effects,” said Dr. Navari. “And as a generic drug, it’s also relatively affordable, with a monthly supply often costing $ 10 to $ 15.”
Current guidelines for managing nausea and vomiting in patients with advanced cancer do not specifically show that a particular drug is substantially superior to a variety of other drugs. However, we believe the current results may be considered best practices for treating nausea and vomiting in patients with nausea and vomiting associated with advanced cancer. “
Charles Loprinzi, M.D. , Medical Oncologist, Mayo Clinic
Source:
See journal:
Navari, R. M., other. (2020) Olanzapine for the treatment of advanced cancer-related chronic nausea and / or vomiting. JAMA Oncology. doi.org/10.1001/jamaoncol.2020.1052.
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