Cancer Supportive Care > Post-Operative Nausea & Vomiting
Post-operative nausea & vomiting (PONV) is a significant issue for patients and healthcare providers. It is rated second only to pain as the complication most feared by patients and contributes significantly to anxiety and patient distress. PONV can also delay patient discharge or result in readmission after in-patient procedures; and can require admission for day-case patients. This has a significant economic and social impact.
PONV is typically managed using a multimodal prophylactic approach, including the use of combination drug therapy. This usually involves intravenous administration of agents to patients before or during the patient’s surgical procedure. There are a number of approved agents in use, and commonly prescribed drugs include 5HT3-antagonists such as ondansetron and granisetron, mixed activity agents such as metoclopramide and the steroid dexamethasone. Until recently the preferred agent of anaesthetists was the dopamine antagonist droperidol, which has fallen into disuse in many key markets due to cardiovascular and psychological safety concerns.
What is PONV?
PONV is a condition that occurs in approximately 30% of all surgical patients, and in 70% of high-risk patients. It is estimated that there are more than 130 million surgical procedures per annum worldwide. Key risk factors for PONV include type and length of surgery, type of anaesthesia and analgesia used, and prior history of PONV or motion sickness. Typically, women are more prone to PONV than men. PONV most commonly starts in the first 3 hours after the end of anaesthesia, with a decreasing incidence over 24 hours.
Related Product Information
Discussions with key opinion leaders and market research have indicated there is a significant unmet need for a dopamine antagonist with a wide therapeutic window and improved safety profile. Acacia Pharma is developing APD421, an intravenous formulation of a well known marketed dopamine D2/D3-antagonist, for the new use of prevention and treatment of PONV.