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Purpose: Data on the efficacy of olanzapine in patients receiving moderately emetogenic chemotherapy (MEC) are limited. This study aimed to evaluate and compare the efficacy of olanzapine versus placebo in controlling nausea and vomiting in patients receiving MEC.
Materials And Methods: We conducted a randomized, double-blind, placebo-controlled study to determine whether olanzapine can reduce the frequency of chemotherapy-induced nausea and vomiting (CINV) and improve the quality of life (QOL) in patients receiving palonosetron and dexamethasone as prophylaxis for MEC-induced nausea and vomiting. The primary end point was complete response for the acute phase (0-24 hours after chemotherapy). The secondary end points were complete response for the delayed (24-120 hours) and overall phase (0-120 hours), proportion of significant nausea (visual analogue scale ≥ 25 mm), use ofrescue medications, and effect on QOL.
Results: Fifty-six patients were randomized to the olanzapine (n=29) and placebo (n=27) groups. Complete response rates were not significantly different between the olanzapine and placebo groups in the acute (96.5% vs. 88.0%, p=0.326), delayed (69.0% vs. 48.0%, p=0.118), and overall phases (69.0% vs. 48.0%, p=0.118). However, the percentage of patients with significant nausea (17.2% vs. 44.0%, p=0.032) and the use of rescue medications (0.03±0.19 vs. 1.88±2.88, p=0.002) were lower in the olanzapine group than in the placebo. Furthermore, the olanzapine group demonstrated better QOL (p=0.015).
Conclusion: Olanzapine combined with palonosetron and dexamethasone significantly improved QOL and vomiting control among previously untreated patients receiving MEC, although the efficacy was limited to the reduction of the frequency of CINV.
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http://dx.doi.org/10.4143/crt.2017.577 | DOI Listing |
Turk Kardiyol Dern Ars
September 2025
Department of Cardiology, Necmettin Erbakan University, School of Medicine, Konya, Turkiye.
Cardiac resynchronization therapy (CRT) improves outcomes in heart failure, but prior interventions like percutaneous mitral annuloplasty may hinder lead placement. We present a 70-year-old male with ischemic cardiomyopathy and severe functional mitral regurgitation who previously received a Carillon device. Due to coronary sinus inaccessibility, left bundle branch area pacing optimized cardiac resynchronization therapy (LOT-CRT) was performed.
View Article and Find Full Text PDFStroke
September 2025
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia. (V.Y., B.C.V.C., L.C., L.O., M.W.P.).
Background: To assess the efficacy and safety of tenecteplase in patients presenting within 24 hours of symptom onset with a large vessel occlusion and target mismatch on perfusion computed tomography.
Methods: ETERNAL-LVO was a prospective, randomized, open-label, blinded end point, phase 3, superiority trial where adult participants with a large vessel occlusion, presenting within 24 hours of onset with salvageable tissue on computed tomography perfusion, were randomized to tenecteplase 0.25 mg/kg or standard care across 11 primary and comprehensive stroke centers in Australia.
Circulation
September 2025
Division of Cardiology, Columbia University Irving Medical Center, New York, NY (S.A.P.).
Background: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK trial, the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions.
View Article and Find Full Text PDFStroke
September 2025
Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University.
Background: Risk stratification in posterior circulation ischemic stroke (PCIS) is challenging. Although the Posterior Circulation Ischemic Stroke Outcome Score (PCISOS) was developed to address this, its utility in minor PCIS and in identifying homogeneous populations for clinical trials or treatment-responsive subgroups remains uncertain.
Methods: CHANCE-2 (Clopidogrel in High-Risk Patients With Acute Non-disabling Cerebrovascular Events-II) was a multicenter, randomized trial that enrolled patients with minor stroke or high-risk transient ischemic attack who carried CYP2C19 loss-of-function alleles.
Dan Med J
August 2025
Research Unit for General Practice, Department of Public Health, University of Southern Denmark.
Introduction: In various countries, an increasing proportion of general practitioner (GP) referrals is returned by hospitals. We aimed to uncover the causes and consequences of referral returns from the perspective of GP liaisons.
Methods: Individual interviews with 20 GP liaison officers from various departments in Southern Denmark, serving 1.