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01.06.2011 | Original Article

Efficacy of palonosetron (PAL) compared to other serotonin inhibitors (5-HT₃R) in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetogenic (MoHE) treatment: systematic review and meta-analysis

verfasst von: Tobias Engel Ayer Botrel, Otávio Augusto C. Clark, Luciana Clark, Luciano Paladini, Enéas Faleiros, Bruna Pegoretti

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2011

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Abstract

Objective

The objective of this work is to perform a systematic review and meta-analysis of all randomized controlled trials comparing a single intravenous dose of palonosetron (PAL) 0.25 mg with other 5-HT₃R in patients receiving moderately or highly emetogenic (MoHE) chemotherapy.

Methods

Several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. The primary endpoints were the incidence of acute and delayed nausea and vomiting. The side effects of each treatment were analyzed. A subgroup analysis was performed to evaluate the influence of the use of corticosteroids. The results are expressed as risk ratio (RR) and the correspondent 95% confidence interval (CI).

Results

Five studies were included, with 2,057 patients. PAL was compared with ondansetron, granisetron, and dolasetron. Patients in PAL group had less nausea, both acute (RR = 0.86; CI95% = 0.76 to 0.96; p = 0.007) and delayed (RR = 0.82; CI95% = 0.75 to 0.89; p < 0.00001). They also had less acute vomiting (RR = 0.76; CI95% = 0.66 to 0.88; p = 0.0002) and delayed vomiting (RR = 0.76; CI95% = 0.68 to 0.85; p < 0.00001). There were no statistical differences in side effects like headache (RR = 0.84; CI95% = 0.61 to 1.17; p = 0.30), dizziness (RR = 0.40; CI95% = 0.13 to 1.27; p = 0.12), constipation (RR = 1.29; CI95% = 0.77 to 2.17; p = 0.33) or diarrhea (RR = 0.67; CI95% = 0.24 to 1.85; p = 0.44). Patients receiving PAL presented less nausea and vomiting regardless of the use of corticoids. We found no statistical heterogeneity in the global analysis.

Conclusion

PAL was more effective than the other 5-HT₃R in preventing acute and delayed CINV in patients receiving MoHE treatments, regardless of the use of concomitant corticosteroids.

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Titel: Efficacy of palonosetron (PAL) compared to other serotonin inhibitors (5-HT3R) in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetogenic (MoHE) treatment: systematic review and meta-analysis
verfasst von: Tobias Engel Ayer Botrel
Otávio Augusto C. Clark
Luciana Clark
Luciano Paladini
Enéas Faleiros
Bruna Pegoretti
Publikationsdatum: 01.06.2011
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 6/2011
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-010-0908-8

Springer Medizin

Efficacy of palonosetron (PAL) compared to other serotonin inhibitors (5-HT₃R) in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetogenic (MoHE) treatment: systematic review and meta-analysis