Abstract | BACKGROUND: METHODS: A retrospective review of CVS patients diagnosed using Rome criteria at a tertiary referral center was conducted. Drug response was defined as >50% reduction in symptoms and/or healthcare utilization. An intent-to-treat (ITT) analysis was conducted. KEY RESULTS: Of 96 patients prescribed aprepitant, 26 (27%) were unable to start due to cost/lack of insurance coverage. Of 70 receiving therapy, mean age was 33 ± 11 years; 51 (73%) were female and 56 (80%) Caucasian. The majority (93%) were refractory to other prophylactic medications. Aprepitant was taken thrice weekly in 51 (73%), daily in 16 (23%) and a few times a month in 3 (4%) due to cost. Fifty (71.4%) had a global symptom response to aprepitant. There was significant reduction in the number of CVS episodes (14.5 ± 11.7 to 6.2 ± 8.0, p < 0.0001), emergency department visits (4.2 ± 7.7 to 1.8 ± 3.4, p = 0.006), and hospital admissions (1.6 ± 3.9 to 0.8 ± 2.1, p = 0.02) in patients treated with aprepitant. Seven (10%) discontinued the drug due to minor side effects. CONCLUSIONS AND INFERENCES:
Aprepitant is a safe and effective prophylactic medication in adults with refractory CVS. Adequate insurance coverage is a major barrier preventing its use.
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Authors | Milan Patel, Omeed Partovi, Harrison Mooers, Katja Kovacic, Zhuping Garacchi, Thangam Venkatesan |
Journal | Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
(Neurogastroenterol Motil)
Vol. 35
Issue 4
Pg. e14530
(04 2023)
ISSN: 1365-2982 [Electronic] England |
PMID | 36740813
(Publication Type: Journal Article)
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Copyright | © 2023 John Wiley & Sons Ltd. |
Chemical References |
- Aprepitant
- Antiemetics
- Morpholines
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Topics |
- Child
- Humans
- Adult
- Female
- Young Adult
- Male
- Aprepitant
(therapeutic use)
- Antiemetics
(therapeutic use)
- Morpholines
(therapeutic use)
- Vomiting
(drug therapy, prevention & control)
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