Study register · detailSystematische Review + Meta-Analyse · Cancer · 2008
Therapeutic use ofCannabis sativaon chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis
MACHADO ROCHA et al.·European Journal of Cancer CareImpact 0.7
Clear benefitGRADEHigh224 citations
Samplek = 30 Studien n = 1.138 Pat.
Durationuntil December 2006
ControlPlacebo and conventional antiemetics
EndpointAntiemetic efficacy
Blindingdoppelblind
DesignSystematische Review + Meta-Analyse
Cannabinoidthc
Routeoral
”Key finding
Cannabinoids showed superior antiemetic efficacy compared to conventional medications and placebo, but were associated with more intense and more frequent side effects.
Summary
SR/MA (k=30 RCTs); cannabinoids (dronabinol, nabilone, levonantradol) vs. placebo or neuroleptics for chemotherapy-induced nausea and vomiting (CINV) in cancer patients. Dronabinol vs. neuroleptics: RR=0,67 (CI 0,47–0,96), NNT=3,4; patient preference cannabinoids vs. other agents: n=1138, RR=0,33 (CI 0,24–0,44), NNT=1,8. Superiority of antiemetic efficacy of cannabinoids over placebo and neuroleptics confirmed.
P
PopulationCancer patients undergoing chemotherapy with chemotherapy-induced nausea and vomiting, pooled n=2119 (across 5 meta-analyses)
I
InterventionCannabinoids (dronabinol, nabilone, levonantradol) as antiemetics
C
ControlPlacebo and conventional antiemetics (neuroleptics)
O
OutcomeDronabinol vs. neuroleptics: RR=0,67 (CI 0,47–0,96, NNT=3,4); patient preference for cannabinoids: RR=0,33 (CI 0,24–0,44, NNT=1,8); cannabinoids showed superior antiemetic efficacy, but more frequent and more intense side effects
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Quality profile
Sample size★★★★★
BlindingDouble-blind
Effect sizeClear benefit
Citations / year★★★★★
Authors
MACHADO ROCHA F, STÉFANO S, DE CÁSSIA HAIEK R et al.
This paper aims to evaluate the anti-emetic efficacy of cannabinoids in cancer patients receiving chemotherapy using a systematic review of literature searched within electronic databases such as PUBMED, EMBASE, PSYCINFO, LILACS, and 'The Cochrane Collaboration Controlled Trials Register'. Studies chosen were randomized clinical trials comprising all publications of each database until December 2006. From 12 749 initially identified papers, 30 fulfilled the inclusion criteria for this review, with demonstration of superiority of the anti-emetic efficacy of cannabinoids compared with conventional drugs and placebo. The adverse effects were more intense and occurred more often among patients who used cannabinoids. Five meta-analyses were carried out: (1) dronabinol versus placebo [n=185; relative risk (RR)=0.47; confidence interval (CI)=0.19-1.16]; (2) Dronabinol versus neuroleptics [n=325; RR=0.67; CI=0.47-0.96; number needed to treat (NNT)=3.4]; (3) nabilone versus neuroleptics (n=277; RR=0.88; CI=0.72-1.08); (4) levonantradol versus neuroleptics (n=194; RR=0.94; CI=0.75-1.18); and (5) patients' preference for cannabis or other drugs (n=1138; RR=0.33; CI=0.24-0.44; NNT=1.8). The superiority of the anti-emetic efficacy of cannabinoids was demonstrated through meta-analysis.