Details der Publikation - Reducing dexamethasone antiemetic prophylaxis during the COVID-19 pandemic: recommendations from Ontario, Canada

Reducing dexamethasone antiemetic prophylaxis during the COVID-19 pandemic: recommendations from Ontario, Canada

Purpose People with cancer face an elevated risk of infection and severe sequelae from COVID-19. Dexamethasone is commonly used for antiemetic prophylaxis with systemic therapy for cancer. However, dexamethasone is associated with increased risk of viral and respiratory infections, and causes lymphopenia, which is associated with worse outcomes during COVID-19 infections. Our purpose was to minimize dexamethasone exposure during antiemetic prophylaxis for systemic therapy for solid tumors during the COVID-19 pandemic, while maintaining control of nausea and emesis. Methods We convened an expert panel to systematically review the literature and formulate consensus recommendations. Results No studies considered the impact of dexamethasone-based antiemetic regimens on the risk and severity of COVID-19 infection. Expert consensus recommended modifications to the 2019 Cancer Care Ontario Antiemetic Recommendations. Conclusion Clinicians should prescribe the minimally effective dose of dexamethasone for antiemetic prophylaxis. Single-day dexamethasone dosing is recommended over multi-day dosing for regimens with high emetogenic risk excluding high-dose cisplatin, preferably in combination with palonosetron, netupitant, and olanzapine. For regimens with low emetogenic risk, 5-$ HT_{3} $ antagonists are recommended over dexamethasone..

Medienart:	E-Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:28
Enthalten in:	Supportive care in cancer - 28(2020), 10 vom: 30. Juni, Seite 5031-5036

Sprache:	Englisch

Beteiligte Personen:	Grant, Robert C. [VerfasserIn] Rotstein, Coleman [VerfasserIn] Liu, Geoffrey [VerfasserIn] Forbes, Leta [VerfasserIn] Vu, Kathy [VerfasserIn] Lee, Roy [VerfasserIn] Ng, Pamela [VerfasserIn] Krzyzanowska, Monika [VerfasserIn] Warr, David [VerfasserIn] Knox, Jennifer [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

Themen:	Antiemetic COVID-19 Chemotherapy Glucocorticoids Supportive care

RVK:	RVK Klassifikation ELIB24

Anmerkungen:	© Springer-Verlag GmbH Germany, part of Springer Nature 2020

doi:	10.1007/s00520-020-05588-6

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2119078718

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520			\|a Purpose People with cancer face an elevated risk of infection and severe sequelae from COVID-19. Dexamethasone is commonly used for antiemetic prophylaxis with systemic therapy for cancer. However, dexamethasone is associated with increased risk of viral and respiratory infections, and causes lymphopenia, which is associated with worse outcomes during COVID-19 infections. Our purpose was to minimize dexamethasone exposure during antiemetic prophylaxis for systemic therapy for solid tumors during the COVID-19 pandemic, while maintaining control of nausea and emesis. Methods We convened an expert panel to systematically review the literature and formulate consensus recommendations. Results No studies considered the impact of dexamethasone-based antiemetic regimens on the risk and severity of COVID-19 infection. Expert consensus recommended modifications to the 2019 Cancer Care Ontario Antiemetic Recommendations. Conclusion Clinicians should prescribe the minimally effective dose of dexamethasone for antiemetic prophylaxis. Single-day dexamethasone dosing is recommended over multi-day dosing for regimens with high emetogenic risk excluding high-dose cisplatin, preferably in combination with palonosetron, netupitant, and olanzapine. For regimens with low emetogenic risk, 5-$ HT_{3} $ antagonists are recommended over dexamethasone.
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Reducing dexamethasone antiemetic prophylaxis during the COVID-19 pandemic: recommendations from Ontario, Canada

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