Comparison of Ramosetron and Palonosetron for Preventing Nausea and Vomiting after Spinal Surgery

Association with ABCB1 Polymorphisms

Jong Wook Song, Jae Kwang Shim, Seung Ho Choi, Sarah Soh, Jaewon Jang, Younglan Kwak

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) polymorphisms may influence 5-hydroxytryptamine receptor antagonist efficacy by altering their efflux transportation. We evaluated the influence of ABCB1 polymorphisms on the efficacy of ramosetron compared with palonosetron in managing postoperative nausea and vomiting (PONV) in patients who received intravenous patient-controlled analgesia after spinal surgery. Methods: Patients were randomly allocated to receive 2 boluses (20 min before the end of surgery and 24 h after surgery) of either ramosetron 0.3 mg (n=150) or palonosetron 0.075 mg (n=146). The incidence and severity of PONV, fentanyl consumption, and pain intensity were serially assessed for postoperative 48 hours. ABCB1 3435C>T and 2677G>T/A polymorphisms were assessed. Results: The incidences of nausea were similar between the 2 groups in patients with the 3435TT (50% vs. 56%, ramosetron and palonosetron group, respectively, P>0.999) or 2677TT (50% vs. 56%, ramosetron and palonosetron group, respectively, P>0.999). Mild PONV were more frequent in the ramosetron group than in the palonosetron group among patients with 3435TT (91% vs. 33%, P=0.034) and 2677TT (92% vs. 20%, P=0.002) genotypes. The intensity of nausea experienced by ramosetron-group TT genotype patients (1 [1 to 2], 3435TT; 1 [1 to 2.5], 2677TT) was lower than that experienced by ramosetron-group non-TT genotype patients (3 [1 to 6], 3435 non-TT, P=0.030; 3 [1 to 6], 2677 non-TT, P=0.038) and palonosetron-group TT genotype patients (6 [2 to 7], 3435TT, P=0.010; 6 [4 to 7], 2677TT, P=0.002). Conclusions: Compared with palonosetron, ramosetron may be superior for reducing PONV severity, especially in patients with ABCB1 3435TT or 2677TT genotype.

Original languageEnglish
Pages (from-to)406-414
Number of pages9
JournalJournal of Neurosurgical Anesthesiology
Volume29
Issue number4
DOIs
Publication statusPublished - 2017 Jan 1

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Nausea
Vomiting
Adenosine Triphosphate
Postoperative Nausea and Vomiting
Genotype
Patient-Controlled Analgesia
Serotonin Antagonists
ramosetron
palonosetron
Serotonin Receptors
Incidence
Fentanyl
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

@article{57ef1c9a24d046e1993fb7934adb9329,
title = "Comparison of Ramosetron and Palonosetron for Preventing Nausea and Vomiting after Spinal Surgery: Association with ABCB1 Polymorphisms",
abstract = "Background: Adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) polymorphisms may influence 5-hydroxytryptamine receptor antagonist efficacy by altering their efflux transportation. We evaluated the influence of ABCB1 polymorphisms on the efficacy of ramosetron compared with palonosetron in managing postoperative nausea and vomiting (PONV) in patients who received intravenous patient-controlled analgesia after spinal surgery. Methods: Patients were randomly allocated to receive 2 boluses (20 min before the end of surgery and 24 h after surgery) of either ramosetron 0.3 mg (n=150) or palonosetron 0.075 mg (n=146). The incidence and severity of PONV, fentanyl consumption, and pain intensity were serially assessed for postoperative 48 hours. ABCB1 3435C>T and 2677G>T/A polymorphisms were assessed. Results: The incidences of nausea were similar between the 2 groups in patients with the 3435TT (50{\%} vs. 56{\%}, ramosetron and palonosetron group, respectively, P>0.999) or 2677TT (50{\%} vs. 56{\%}, ramosetron and palonosetron group, respectively, P>0.999). Mild PONV were more frequent in the ramosetron group than in the palonosetron group among patients with 3435TT (91{\%} vs. 33{\%}, P=0.034) and 2677TT (92{\%} vs. 20{\%}, P=0.002) genotypes. The intensity of nausea experienced by ramosetron-group TT genotype patients (1 [1 to 2], 3435TT; 1 [1 to 2.5], 2677TT) was lower than that experienced by ramosetron-group non-TT genotype patients (3 [1 to 6], 3435 non-TT, P=0.030; 3 [1 to 6], 2677 non-TT, P=0.038) and palonosetron-group TT genotype patients (6 [2 to 7], 3435TT, P=0.010; 6 [4 to 7], 2677TT, P=0.002). Conclusions: Compared with palonosetron, ramosetron may be superior for reducing PONV severity, especially in patients with ABCB1 3435TT or 2677TT genotype.",
author = "Song, {Jong Wook} and Shim, {Jae Kwang} and Choi, {Seung Ho} and Sarah Soh and Jaewon Jang and Younglan Kwak",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/ANA.0000000000000361",
language = "English",
volume = "29",
pages = "406--414",
journal = "Journal of Neurosurgical Anesthesiology",
issn = "0898-4921",
publisher = "Lippincott Williams and Wilkins",
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}

Comparison of Ramosetron and Palonosetron for Preventing Nausea and Vomiting after Spinal Surgery : Association with ABCB1 Polymorphisms. / Song, Jong Wook; Shim, Jae Kwang; Choi, Seung Ho; Soh, Sarah; Jang, Jaewon; Kwak, Younglan.

In: Journal of Neurosurgical Anesthesiology, Vol. 29, No. 4, 01.01.2017, p. 406-414.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of Ramosetron and Palonosetron for Preventing Nausea and Vomiting after Spinal Surgery

T2 - Association with ABCB1 Polymorphisms

AU - Song, Jong Wook

AU - Shim, Jae Kwang

AU - Choi, Seung Ho

AU - Soh, Sarah

AU - Jang, Jaewon

AU - Kwak, Younglan

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) polymorphisms may influence 5-hydroxytryptamine receptor antagonist efficacy by altering their efflux transportation. We evaluated the influence of ABCB1 polymorphisms on the efficacy of ramosetron compared with palonosetron in managing postoperative nausea and vomiting (PONV) in patients who received intravenous patient-controlled analgesia after spinal surgery. Methods: Patients were randomly allocated to receive 2 boluses (20 min before the end of surgery and 24 h after surgery) of either ramosetron 0.3 mg (n=150) or palonosetron 0.075 mg (n=146). The incidence and severity of PONV, fentanyl consumption, and pain intensity were serially assessed for postoperative 48 hours. ABCB1 3435C>T and 2677G>T/A polymorphisms were assessed. Results: The incidences of nausea were similar between the 2 groups in patients with the 3435TT (50% vs. 56%, ramosetron and palonosetron group, respectively, P>0.999) or 2677TT (50% vs. 56%, ramosetron and palonosetron group, respectively, P>0.999). Mild PONV were more frequent in the ramosetron group than in the palonosetron group among patients with 3435TT (91% vs. 33%, P=0.034) and 2677TT (92% vs. 20%, P=0.002) genotypes. The intensity of nausea experienced by ramosetron-group TT genotype patients (1 [1 to 2], 3435TT; 1 [1 to 2.5], 2677TT) was lower than that experienced by ramosetron-group non-TT genotype patients (3 [1 to 6], 3435 non-TT, P=0.030; 3 [1 to 6], 2677 non-TT, P=0.038) and palonosetron-group TT genotype patients (6 [2 to 7], 3435TT, P=0.010; 6 [4 to 7], 2677TT, P=0.002). Conclusions: Compared with palonosetron, ramosetron may be superior for reducing PONV severity, especially in patients with ABCB1 3435TT or 2677TT genotype.

AB - Background: Adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) polymorphisms may influence 5-hydroxytryptamine receptor antagonist efficacy by altering their efflux transportation. We evaluated the influence of ABCB1 polymorphisms on the efficacy of ramosetron compared with palonosetron in managing postoperative nausea and vomiting (PONV) in patients who received intravenous patient-controlled analgesia after spinal surgery. Methods: Patients were randomly allocated to receive 2 boluses (20 min before the end of surgery and 24 h after surgery) of either ramosetron 0.3 mg (n=150) or palonosetron 0.075 mg (n=146). The incidence and severity of PONV, fentanyl consumption, and pain intensity were serially assessed for postoperative 48 hours. ABCB1 3435C>T and 2677G>T/A polymorphisms were assessed. Results: The incidences of nausea were similar between the 2 groups in patients with the 3435TT (50% vs. 56%, ramosetron and palonosetron group, respectively, P>0.999) or 2677TT (50% vs. 56%, ramosetron and palonosetron group, respectively, P>0.999). Mild PONV were more frequent in the ramosetron group than in the palonosetron group among patients with 3435TT (91% vs. 33%, P=0.034) and 2677TT (92% vs. 20%, P=0.002) genotypes. The intensity of nausea experienced by ramosetron-group TT genotype patients (1 [1 to 2], 3435TT; 1 [1 to 2.5], 2677TT) was lower than that experienced by ramosetron-group non-TT genotype patients (3 [1 to 6], 3435 non-TT, P=0.030; 3 [1 to 6], 2677 non-TT, P=0.038) and palonosetron-group TT genotype patients (6 [2 to 7], 3435TT, P=0.010; 6 [4 to 7], 2677TT, P=0.002). Conclusions: Compared with palonosetron, ramosetron may be superior for reducing PONV severity, especially in patients with ABCB1 3435TT or 2677TT genotype.

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JO - Journal of Neurosurgical Anesthesiology

JF - Journal of Neurosurgical Anesthesiology

SN - 0898-4921

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