In all the vestipitant treatmentgroups, the reasons for treatment
failure were primarily due to the requirement for further
rescue medication (35%), rather than being due to emesis and
retching (9%). In contrast, the reasons for treatment failure in
the ondansetron arm were predominantly due to emesis and
Randomization
n=572
Prophylaxis including
ondansetron 4 mg i.v.
Surgery
Breakthrough PONV
n=130 dosed
Ondansetron
4 mg i.v.
n=19
Vestipitant
6 mg i.v.
n=23
Vestipitant
12 mg i.v.
n=23
Vestipitant
18 mg i.v.
n=23
Vestipitant
24 mg i.v.
n=20
Vestipitant
36 mg i.v.
n=22
Fig 1 Study schematic.
Table 2 Analysis of complete response rate (intent-to-treat population). No differences in complete response between the vestipitant
and ondansetron groups were observed based on posterior probability of success. NA, not applicable
Ondansetron Vestipitant
4mg (n519) 6 mg
(n524)
12 mg
(n523)
18 mg
(n522)
24 mg
(n520)
36 mg
(n522)
Total
(n5111)
Complete response (n) 8 15 12 9 13 13 62
Complete response rate (%) 42.1 62.5 52.2 40.9 65.0 59.1 55.9
Improvement from control
(vestipitant–ondansetron)%
20.4 10.1 21.2 22.9 17.0 13.8
Posterior probability of success 0.222 0.052 0.039 0.065 0.254 N/A
Treatment failure (TF) [n (%)] 11 (57.9) 9 (37.5) 11(47.8) 13 (59.1) 7 (35.0) 9 (40.9) 49 (44.1)
Primary reason for TF [n (%)]
Emesis/retching 7 (36.8) 3 (12.5) 1 (4.3) 3 (13.6) 1 (5.0) 2 (9.1) 10 (9.0)
Rescue medication 4 (21.1) 6 (25.0) 10 (43.5) 10 (45.5) 6 (30.0) 7 (31.8) 39 (35.1)
Emesis/retching after rescue
medication (n)
1 1 6 2 2 4 15
BJA Kranke et al.
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retching (37%) compared with the need for further rescue
medication (21%). Similar results were obtained when data
excluded six patients with major protocol deviations.