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Abstract：
BACKGROUND: The current utilization of neurokinin-1 receptor antagonists (NK1RAs) and the impact of updated guidelines on prescription patterns of antiemetic drugs among Chinese patients receiving highly emetogenic chemotherapy (HEC) remain undetermined. This study aims to analyze the present situation of Chinese cancer patients using antiemetic drugs and assess the appropriateness of antiemetic regimens.
METHODS: Prescription data were collected between January 2015 and December 2020 from cancer patients receiving cisplatin-based chemotherapy at 76 hospitals in six major cities in China. Trends in the use of antiemetic drugs, prescribing patterns and adherence to antiemetic guidelines were assessed.
RESULTS: Among the 108,611 patients included in this study, 6 classes and 17 antiemetic drugs were identified as monotherapy or combination therapy in 93,872 patients (86.4%), whereas 14,739 patients (13.6%) were administered no antiemetic treatment. 5-hydroxytryptamine 3 receptor antagonists (5-HT3RAs) and glucocorticoids were the two most frequently used classes of antiemetics, followed by metoclopramide. NK1RAs were underused across the six cities, only 9332 (8.6%) and 1655 (1.5%) cisplatin-based treatments were prescribed aprepitant and fosaprepitant, respectively. Prescriptions of olanzapine and lorazepam were very low throughout the study period. In prescribing patterns of antiemetic drugs, dual combination regimens were the most common (40.0%), followed by triple combination therapy and monotherapy (25.8% and 15.1%, respectively). Overall, the adherence to antiemetic guidelines for patients undergoing cisplatin-based regimens was only 8.1% due to inadequate prescription of antiemetic drugs. Finally, our study also revealed that 5-HT3RAs and glucocorticoids were overprescribed in 8.8% and 1.6% of patients, respectively.
CONCLUSIONS: The current study reveals suboptimal utilization of recommended antiemetic drugs for managing cisplatin-based HEC-induced nausea and vomiting in China. Improving the management of CINV is crucial, and these findings provide valuable insights into optimizing antiemetic drug practices.
METHODS: Prescription data were collected between January 2015 and December 2020 from cancer patients receiving cisplatin-based chemotherapy at 76 hospitals in six major cities in China. Trends in the use of antiemetic drugs, prescribing patterns and adherence to antiemetic guidelines were assessed.
RESULTS: Among the 108,611 patients included in this study, 6 classes and 17 antiemetic drugs were identified as monotherapy or combination therapy in 93,872 patients (86.4%), whereas 14,739 patients (13.6%) were administered no antiemetic treatment. 5-hydroxytryptamine 3 receptor antagonists (5-HT3RAs) and glucocorticoids were the two most frequently used classes of antiemetics, followed by metoclopramide. NK1RAs were underused across the six cities, only 9332 (8.6%) and 1655 (1.5%) cisplatin-based treatments were prescribed aprepitant and fosaprepitant, respectively. Prescriptions of olanzapine and lorazepam were very low throughout the study period. In prescribing patterns of antiemetic drugs, dual combination regimens were the most common (40.0%), followed by triple combination therapy and monotherapy (25.8% and 15.1%, respectively). Overall, the adherence to antiemetic guidelines for patients undergoing cisplatin-based regimens was only 8.1% due to inadequate prescription of antiemetic drugs. Finally, our study also revealed that 5-HT3RAs and glucocorticoids were overprescribed in 8.8% and 1.6% of patients, respectively.
CONCLUSIONS: The current study reveals suboptimal utilization of recommended antiemetic drugs for managing cisplatin-based HEC-induced nausea and vomiting in China. Improving the management of CINV is crucial, and these findings provide valuable insights into optimizing antiemetic drug practices.
摘要：
背景：目前神经激肽-1受体拮抗剂（NK1RAs）的使用情况以及最新指南对接受高致吐化疗（HEC）的中国患者止吐药处方模式的影响仍不确定。本研究旨在分析中国癌症患者使用止吐药物的现状，并评估止吐方案的适当性。
方法：收集了2015年1月至2020年12月在中国6个主要城市的76家医院接受顺铂化疗的癌症患者的处方数据。止吐药的使用趋势，对处方模式和止吐指南的依从性进行了评估.
结果：在本研究纳入的108,611名患者中，在93,872例患者中，有6类和17种止吐药被确定为单药或联合治疗（86.4％），而14,739例患者（13.6%）未给予止吐治疗。5-羟色胺3受体拮抗剂（5-HT3RAs）和糖皮质激素是两种最常用的止吐药，其次是甲氧氯普胺。NK1RA在六个城市中使用不足，只有9332（8.6％）和1655（1.5％）顺铂为基础的治疗规定阿瑞吡坦和福沙吡坦，分别。在整个研究期间，奥氮平和劳拉西泮的处方非常低。在止吐药的处方模式中，双重组合方案最常见(40.0%)，其次是三联疗法和单一疗法(25.8%和15.1%，分别)。总的来说,由于止吐药处方不足,接受以顺铂为基础的方案的患者对止吐指南的依从性仅为8.1%.最后,我们的研究还显示，5-HT3RAs和糖皮质激素在8.8%和1.6%的患者中被过量处方，分别。
结论：目前的研究表明，在中国，推荐的止吐药物用于治疗以顺铂为基础的HEC引起的恶心和呕吐。改善CINV的管理至关重要，这些发现为优化止吐药物实践提供了有价值的见解。
方法：收集了2015年1月至2020年12月在中国6个主要城市的76家医院接受顺铂化疗的癌症患者的处方数据。止吐药的使用趋势，对处方模式和止吐指南的依从性进行了评估.
结果：在本研究纳入的108,611名患者中，在93,872例患者中，有6类和17种止吐药被确定为单药或联合治疗（86.4％），而14,739例患者（13.6%）未给予止吐治疗。5-羟色胺3受体拮抗剂（5-HT3RAs）和糖皮质激素是两种最常用的止吐药，其次是甲氧氯普胺。NK1RA在六个城市中使用不足，只有9332（8.6％）和1655（1.5％）顺铂为基础的治疗规定阿瑞吡坦和福沙吡坦，分别。在整个研究期间，奥氮平和劳拉西泮的处方非常低。在止吐药的处方模式中，双重组合方案最常见(40.0%)，其次是三联疗法和单一疗法(25.8%和15.1%，分别)。总的来说,由于止吐药处方不足,接受以顺铂为基础的方案的患者对止吐指南的依从性仅为8.1%.最后,我们的研究还显示，5-HT3RAs和糖皮质激素在8.8%和1.6%的患者中被过量处方，分别。
结论：目前的研究表明，在中国，推荐的止吐药物用于治疗以顺铂为基础的HEC引起的恶心和呕吐。改善CINV的管理至关重要，这些发现为优化止吐药物实践提供了有价值的见解。
