Olanzapine FTW for Nausea Outside of CINV

by Drew Rosielle (@drosielle)A few months agoan interesting olanzapine study was published which I have been meaning to write a post about. It ' s important because while olanzapine has really established itself in the last decade as a highly effective antiemetic for chemotherapy induced nausea and vomiting, and is now in multiple CINV guidelines (eg Antiemetics: ASCO Guideline), etc, we don ' t have a lot of data for its efficacy for nausea outside of CINV, and so a well-done RCT is welcome.The study is amulti-center, US, adult, randomized, placebo-controlled, double-blind trial of olanzapine for nausea in advanced cancer patients who are not receiving chemo. (Small note: the abstract says ' double-line ' instead of ' double-blind, ' and as someone who does my best to edit typos from my and others ' work all the time, it is just interesting and kind of quaint to see such a typo in a JAMA journal. I actually tried to figure out if ' double-line ' is some novel trial design I had missed but I ' m pretty sure it is not.) While well-done, it is a small study and is described as a pilot study by the investigators.Patients (n=30, ~45% Black American and the rest mostly white, mean age ~60 years, broad spectrum of solid tumors represented, most were on either/both metoclopramide/ondansetron at baseline) had to have chronic nausea for at least a week rated>3 on a 0-10 scale, not be on chemo for at least 2 weeks (for the most part CINV is defined as chemo on days 0-5 of chemothera...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: anorexia cachexia nausea olanzapine rosielle Source Type: blogs