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Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis
BACKGROUND: Chemotherapy induced nausea and vomiting (CINV) remains the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). OBJECTIVE: Therefore, this meta-analysis was conducted to evaluate the efficacy of olanzapine contain...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Centro de Investigaciones y Publicaciones Farmaceuticas
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386623/ https://www.ncbi.nlm.nih.gov/pubmed/28503222 http://dx.doi.org/10.18549/PharmPract.2017.01.877 |
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author | Chelkeba, Legese Gidey, Kidu Mamo, Ayele Yohannes, Berhane Matso, Tsehay Melaku, Tsegaye |
author_facet | Chelkeba, Legese Gidey, Kidu Mamo, Ayele Yohannes, Berhane Matso, Tsehay Melaku, Tsegaye |
author_sort | Chelkeba, Legese |
collection | PubMed |
description | BACKGROUND: Chemotherapy induced nausea and vomiting (CINV) remains the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). OBJECTIVE: Therefore, this meta-analysis was conducted to evaluate the efficacy of olanzapine containing regimen in preventing acute, delayed and overall phases of CINV. METHODS: PubMed, EBSCO, and Cochrane central register of controlled trials electronic databases were searched to identify RCTs that compared the effects of olanzapine with non-olanzapine regimen in preventing CINV. Randomized clinical trials (RCTs) that compared olanzapine containing regimen with non-olanzapine regimen were included. The primary outcomes were the percentage of patients achieving no vomiting or no nausea in acute, delayed and overall phases. RESULTS: 13 RCTs that enrolled 1686 participants were included in this meta-analysis. 852 patients were assigned to olanzapine and 834 patients were assigned to non-olanzapine regimen (other standard antiemetic regimen). The percentages of no emesis achieved were 87.5%, 76.2%, 73.6% in olanzapine versus 76.7%, 61.8%, and 56.4% in non-olanzapine regimen in acute, delayed and overall phases, respectively. The percentages of no nausea were 82%, 64.3%, 61.6% in olanzapine group versus 71.3%, 41.8%, and 40.6% in non-olanzapine group in acute, delayed and overall phases, respectively. In general, olanzapine containing regimen achieved statistical superiority to non-olanzapine regimen in no vomiting endpoint in acute phase (OR 2.16; 95%CI 1.60 to 2.91, p<0.00001; I-square=5%; p=0.40), delayed phase (OR 2.28; 95%CI 1.1.46 to 3.54, p=0.0003; I-square=65%; p=0.001) and overall phase (OR 2.48; 95%CI 1.59 to 3.86, p<0.0001; I-square=69%; p< 0.0001). CONCLUSION: The current meta-analysis showed that olanzapine was statistically and clinically superior to non-olanzapine regimen in preventing CINV in most domains of the parameters. |
format | Online Article Text |
id | pubmed-5386623 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Centro de Investigaciones y Publicaciones Farmaceuticas |
record_format | MEDLINE/PubMed |
spelling | pubmed-53866232017-05-12 Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis Chelkeba, Legese Gidey, Kidu Mamo, Ayele Yohannes, Berhane Matso, Tsehay Melaku, Tsegaye Pharm Pract (Granada) Original Research BACKGROUND: Chemotherapy induced nausea and vomiting (CINV) remains the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). OBJECTIVE: Therefore, this meta-analysis was conducted to evaluate the efficacy of olanzapine containing regimen in preventing acute, delayed and overall phases of CINV. METHODS: PubMed, EBSCO, and Cochrane central register of controlled trials electronic databases were searched to identify RCTs that compared the effects of olanzapine with non-olanzapine regimen in preventing CINV. Randomized clinical trials (RCTs) that compared olanzapine containing regimen with non-olanzapine regimen were included. The primary outcomes were the percentage of patients achieving no vomiting or no nausea in acute, delayed and overall phases. RESULTS: 13 RCTs that enrolled 1686 participants were included in this meta-analysis. 852 patients were assigned to olanzapine and 834 patients were assigned to non-olanzapine regimen (other standard antiemetic regimen). The percentages of no emesis achieved were 87.5%, 76.2%, 73.6% in olanzapine versus 76.7%, 61.8%, and 56.4% in non-olanzapine regimen in acute, delayed and overall phases, respectively. The percentages of no nausea were 82%, 64.3%, 61.6% in olanzapine group versus 71.3%, 41.8%, and 40.6% in non-olanzapine group in acute, delayed and overall phases, respectively. In general, olanzapine containing regimen achieved statistical superiority to non-olanzapine regimen in no vomiting endpoint in acute phase (OR 2.16; 95%CI 1.60 to 2.91, p<0.00001; I-square=5%; p=0.40), delayed phase (OR 2.28; 95%CI 1.1.46 to 3.54, p=0.0003; I-square=65%; p=0.001) and overall phase (OR 2.48; 95%CI 1.59 to 3.86, p<0.0001; I-square=69%; p< 0.0001). CONCLUSION: The current meta-analysis showed that olanzapine was statistically and clinically superior to non-olanzapine regimen in preventing CINV in most domains of the parameters. Centro de Investigaciones y Publicaciones Farmaceuticas 2017 2017-03-15 /pmc/articles/PMC5386623/ /pubmed/28503222 http://dx.doi.org/10.18549/PharmPract.2017.01.877 Text en Copyright: © 2017 Pharmacy Practice and The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Chelkeba, Legese Gidey, Kidu Mamo, Ayele Yohannes, Berhane Matso, Tsehay Melaku, Tsegaye Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
title | Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
title_full | Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
title_fullStr | Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
title_full_unstemmed | Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
title_short | Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
title_sort | olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386623/ https://www.ncbi.nlm.nih.gov/pubmed/28503222 http://dx.doi.org/10.18549/PharmPract.2017.01.877 |
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