←Nausea
Study register · detail Randomized Controlled Trial · Nausea · 1981

Antiemetic effect of delta 9-tetrahydrocannabinol in chemotherapy-associated nausea and emesis as compared to placebo and compazine.

Orr et al. ·Journal of Clinical Pharmacology Impact 1.8
Clear benefit GRADE Moderate 53 citations
Samplen = 55 Pat.
Durationunclear
ControlProchlorperazine and placebo
EndpointNausea/emesis
Blindingdoppelblind
DesignRandomized Controlled Trial
Cannabinoidthc
Routeoral
Key finding

THC showed a markedly superior antiemetic effect (40/55 patients without nausea) compared to prochlorperazine (8/55) and placebo (5/55), with statistical significance (P < 0,005).

Summary

Double-blind, randomized crossover study (n=55 cancer patients with chemo-induced nausea): THC suppressed nausea in 40/55 patients (73%), prochlorperazine in 8/55 (15%), placebo in 5/55 (9%). THC significantly superior to prochlorperazine (p<0,005).

P
PopulationCancer patients with severe chemotherapy-induced nausea/emesis, n=55
I
InterventionDelta-9-tetrahydrocannabinol (THC), oral, dose not specified
C
ControlProchlorperazine (Compazine) and placebo
O
OutcomeNausea absent in 40/55 under THC vs. 8/55 under prochlorperazine vs. 5/55 under placebo (p<0.005)
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
DOI 10.1002/j.1552-4604.1981.tb02578.x↗
Design: Randomized Controlled Trial
Share
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. delta 9-Tetrahydrocannabinol (THC), prochlorperazine, and placebo were compared. Nausea was absent in 40 of 55 patients receiving THC, in 8 of 55 patients receiving prochlorperazine, and in 5 of 55 in the placebo group. THC appeared to be more efficacious in controlling the emesis associated with cyclophosphamide, 5-fluorouracil, and doxorubicin and less so for nitrogen mustard and the nitrosourea. THC appears to offer significant control of nausea in most patients and exceeds by far that provided by prochlorperazine (P less than 0.005).
Indication
Further studies on Nausea
All studies →
S Tramèr et al. · 2001 · BMJ
604 citations
Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review
Mixed Systematische Review + Meta-Analyse

Systematische Review über k=30 RCTs (n=1.366) zu Cannabinoiden bei chemotherapie-induzierter Übelkeit. Cannabinoide (Nabilon, Dronabinol, Levonantradol oral/i.m.) vs. konventionelle Antiemetika (Prochlorperazin, Metoclopramid u.a.): RR=1.38 (95% CI 1.18-1.62, NNT=6) für komplette Übelkeitskontrolle; RR=1.28 (1.08-1.51, NNT=8) für komplette Erbrechenskontrolle. Patientenpräferenz für Cannabinoide: RR=2.39 (2.05-2.78, NNT=3). Häufigere Nebenwirkungen: Schwindel NNT=3, Dysphorie NNT=8, Halluzinationen NNT=17, Paranoia NNT=20, Hypotonie NNT=7. Abbruch wegen Nebenwirkungen: RR=4.67 (3.07-7.09, NNT=11).

10.1136/bmj.323.7303.16 View study →
S Smith et al. · 2015 · Cochrane Database of Systematic Reviews
254 citations
Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy
Mixed Cochrane Systematische Review

Cochrane SR über k=23 RCTs (1975-1991) zu Cannabinoiden bei chemotherapie-induzierter Übelkeit und Erbrechen. Cannabinoide (Nabilon, Dronabinol, Levonantradol) vs. konventionelle Antiemetika: RR=1.38 (95% CI 1.18-1.62, NNT=6) für komplette Übelkeitskontrolle; RR=1.28 (1.08-1.51, NNT=8) für komplette Erbrechenskontrolle. Patienten bevorzugten Cannabinoide für zukünftige Zyklen: RR=2.39 (2.05-2.78, NNT=3). Häufigere Nebenwirkungen: Schwindel RR=2.97 (NNT=3), Euphorie NNT=7, Halluzinationen NNT=17, Paranoia NNT=20.

10.1002/14651858.cd009464.pub2 View study →
S Whiting et al. · 2015 · JAMA
2103 citations
Cannabinoids for Medical Use
Mixed

Umfassende SR über 79 RCTs (n=6.462) zu medizinischem Cannabis; moderate Evidenz für Chemotherapie-induzierte Übelkeit/Erbrechen (CINV): Cannabinoide vs. Placebo zeigten signifikante Überlegenheit (OR=3.82, 95% CI 1.55–9.42), vergleichbare Wirksamkeit zu konventionellen Antiemetika bei höherer Nebenwirkungsrate.

10.1001/jama.2015.6358 View study →

The impediment to action advances action. — Marcus Aurelius