Olanzapine greatly effective in Vomiting Control in children undergoing Chemotherapy

In a new study conducted by Abdul W. Moothedath and team showed that in the delayed period, olanzapine considerably improved total control of vomiting. In the olanzapine group, a much lower proportion of patients required rescue drugs.

The goal of this work was to assess the safety and effectiveness of olanzapine in children following severely emetogenic chemotherapy. The findings of this were published in Journal of Pediatric Hematology/Oncology on 28th January, 2022.

Patients aged 3 to 18 years were randomly allocated to either the olanzapine or placebo groups in this trial. Intravenous ondansetron and dexamethasone were given to all patients 30 minutes before highly emetogenic treatment, followed by oral ondansetron for 48 hours. On days 1 and 2, participants in the olanzapine group got olanzapine once daily, whereas those in the control group received a placebo in the same dosage and timing. The major goal was to compare (a) the complete control rates of vomiting in the delayed phase and (b) the complete control rates of vomiting in the acute and overall phases. The secondary goal was to assess olanzapine's safety and the necessity for emergency drugs.

The results of this study stated as follow:

1. A total of 128 patients were randomly allocated to either the olanzapine (n=63) or the control (n=65) groups.

2. In the delayed period, complete control of vomiting was 73% against 48% (P=0.005) in the olanzapine group, 60% compared 54% (P=0.46) in the acute phase, and 48% versus 34% (P=0.117) in the overall phase, respectively.

3. The olanzapine group had more grade 1 and 2 sedation (46% vs. 14%; P0.001).

4. When compared to the olanzapine group, a substantially larger proportion of patients in the placebo group required rescue drugs for vomiting (P=0.025).

In conclusion, "the findings of this work support in favor of olanzapine in use for vomiting control, although higher sample size is needed for more accurate data," said the Authors.

Reference:

Moothedath AW, Meena JP, Gupta AK, Velpandian T, Pandey RM, Seth R. Efficacy and Safety of Olanzapine in Children Receiving Highly Emetogenic Chemotherapy: A Randomized, Double-blind Placebo-controlled Phase 3 Trial. J Pediatr Hematol Oncol. 2022 Jan 28. doi:10.1097/MPH.0000000000002408.