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Study register · detail Randomized Controlled Trial (double-blind, crossover) · Cancer · 1980

Antiemetic effect of tetrahydrocannabinol. Compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis.

Orr et al. ·Archives of Internal Medicine
Clear benefit GRADE Moderate 92 citations
Samplen = 55 Pat.
Durationunclear
ControlProchlorperazine and placebo
EndpointFreedom from nausea
Blindingdoppelblind
DesignRandomized Controlled Trial (double-blind, crossover)
Cannabinoidthc
Routeoral
Key finding

THC showed superior antiemetic efficacy compared to prochlorperazine and placebo: nausea was absent in 40/55 patients under THC, 8/55 under prochlorperazine and 5/55 under placebo.

Summary

Randomized, double-blind crossover RCT (n=55 cancer patients with chemotherapy-related nausea/vomiting). THC showed clearly superior antiemetic effect: nausea completely absent in 40/55 patients under THC vs. 8/55 under prochlorperazine vs. 5/55 under placebo. THC effective in particular with cyclophosphamide-, fluorouracil- and doxorubicin-containing regimens.

P
PopulationOncological patients with severe chemotherapy-induced vomiting/nausea, n=55
I
InterventionTetrahydrocannabinol (THC), oral, dose not specified
C
ControlProchlorperazine and placebo
O
OutcomeNausea absent in 40/55 (THC) vs. 8/55 (prochlorperazine) vs. 5/55 (placebo); THC significantly superior
Confidence in the evidence
Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for
Imprecision
Quality profile
Sample size ★★★★★
Blinding Double-blind
Effect size Clear benefit
Citations / year ★★★★★
Authors
Orr LE, McKernan JF, Bloome B
DOI 10.1001/archinte.140.11.1431↗
Design: Randomized Controlled Trial (double-blind, crossover)
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Abstract
Fifty-five patients harboring a variety of neoplasms and previously found to have severe nausea or emesis from antitumor drugs were given antiemetic prophylaxis in a double-blind, randomized, crossover fashion. Tetrahydrocannabinol (THC), prochlorperazine, and placebo were compared. Nausea was absent in 40 of 55 patients receiving THC, eight of 55 patients receiving prochlorperazine, and five of 55 in the placebo group. The antiemetic effect of THC appeared to be more efficacious for cyclophosphamide, fluorouracil, and doxorubicin hydrochloride, and less so for mechlorethamine hydrochloride and the nitrosureas. Tetrahydrocannabinol appears to offer significant control of nausea in most patients and exceeding by far that provided by prochlorperazine.
Indication
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The impediment to action advances action. — Marcus Aurelius