Nabilone: an effective antiemetic in patients receiving cancer chemotherapy.

Einhorn et al. ·Journal of Clinical Pharmacology Impact 1.8

Clear benefit GRADE Moderate 91 citations

Samplen = 80 Pat.

Durationtwo consecutive chemotherapy…

ControlProchlorperazine

EndpointAntiemetic efficacy

Blindingdoppelblind

DesignRandomized Controlled Trial

Cannabinoidthc

Routeoral

Key finding

75% of patients reported that nabilone was more effective than prochlorperazine against nausea and vomiting; 46 of these 60 patients continued nabilone as their antiemetic of choice.

Summary

n=80 cancer patients undergoing cisplatin-containing chemotherapy; double-blind crossover RCT: 75 % (60/80) preferred nabilone over prochlorperazine for control of nausea and vomiting; 46 of the 60 responders chose nabilone permanently as their antiemetic of choice.

PopulationCancer patients undergoing chemotherapy (predominantly cisplatin-based), n=80

InterventionNabilone (synthetic cannabinoid), oral, crossover design

ControlProchlorperazine (active control)

Outcome75 % of patients (60/80) reported nabilone to be more effective against nausea and vomiting than prochlorperazine

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

Einhorn LH, Nagy C, Furnas B, Williams SD

DOI 10.1002/j.1552-4604.1981.tb02576.x↗

Design: Randomized Controlled Trial

Abstract

Eighty evaluable patients receiving chemotherapy were entered on a random prospective double-blind study to evaluate the effectiveness of nabilone, a synthetic cannabinoid, compared to prochlorperazine. Most of these patients received cisplatin, a drug that universally produces severe nausea and vomiting, as part of a combination chemotherapy regimen. The patients served as their own controls, receiving either nabilone or prochlorperazine during two consecutive treatment courses with the identical chemotherapy. Side effects consisting of hypotension and lethargy were more pronounced with nabilone. Toxicity, in general, did not preclude antiemetic treatment and in no way interfered with chemotherapy. Sixty patients (75 per cent) reported nabilone to be more effective than prochlorperazine for relief of nausea and vomiting. Of these 60 patients, 46 required further chemotherapy and continued taking nabilone as the antiemetic of choice.

The impediment to action advances action. — Marcus Aurelius