Discussion
CINV, morning sickness
SECONDARY
To our knowledge, this secondary analysis was the first to examine the add-on effect of olanzapine according to risk factors for CINV in the J-FORCE trial. Six major risk factors for CINV were analyzed.As shown in The addition of olanzapine normalized the RDs across age groups and between patients with vs without a history of morning sickness during pregnancy. In the placebo group, the proportion of patients showing a CR and CC in both acute and delayed phases was lower for those younger than 55 years who were at high risk of CINV. However, the proportions of patients showing a CR and CC were the same between those 55 years or older or younger than 55 years in the olanzapine group. The RD between olanzapine and placebo groups for delayed CR and CC was approximately 2-fold higher in patients younger than 55 years than those 55 years or older, suggesting that the addition of olanzapine reduced the difference in risk by age. Regarding morning sickness during pregnancy, the proportion of patients showing a CR and CC in both acute and delayed phases (RD, 15.3% and 28.2%) was lower in those with a history of morning sickness during pregnancy, who were at higher risk of CINV. However, since the proportion of patients showing a CR and CC was higher in the olanzapine vs placebo group in patients with a history of morning sickness during pregnancy in the acute (RD, 12.3%-12.4%) and delayed (RD, 27.2%) phases, the RD became smaller (4.0%-4.9%).Concerning a report that the RD was reduced by adding a new antiemetic, RD by sex decreased with the addition of aprepitant.