Do 5-hydroxytryptamine<sub>3</sub> receptor antagonists (5-HT<sub>3</sub>) improve the antiemetic effect of dexamethasone for preventing delayed chemotherapy-induced nausea and vomiting (CINV)? A meta-analysis of randomized controlled trials

Huang, Jeng-Chai; Zheng, G. F.; Deuson, Robert; Briand, Yves; Chan, Godfrey Chi Fung; Karlberg, Jonas; Wong, Benjamin C Y

doi:10.1200/jco.2004.22.90140.6037

Cited by 7 publications

(6 citation statements)

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“…A meta-analysis of randomized controlled clinical trials concluded that the addition of 5HT 3 receptor antagonist drugs to the dexamethasone-containing regimen did not increase the antiemetic effect of corticosteroids in preventing the late stage of CINV. 17 Latreille et al also found that granisetron for prophylaxis of the late stage of CINV did not confer any additional benefit when compared to the use of isolated corticosteroids. 18 Still, Smyth et al reported that there was no significant difference in the control of late emesis between granisetron and placebo during days 2 to 4 after highly emetogenic chemotherapy (high dose of cisplatin).…”

Section: Resultsmentioning

confidence: 97%

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Lázaro¹,

Carlotto²,

Rotta³

2020

Rev Bras Farm Hosp Serv Saude

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Peer review: blind reviewer and Annemeri Livinallli Objectives: To assess if the antiemetic prophylaxis prescribed to patients exposed to chemotherapy is following the Antiemesis guideline published by the National Comprehensive Cancer Network (NCCN) version 3.2018. Methods: A medication review was performed, considering antiemetic´s prescriptions of adult patients under treatment with moderate and high emetogenic potential antineoplastic agents, assisted on an outpatient basis in a tertiary public hospital, from May to September 2019. The information contained in the prescriptions was compared with the guideline recommendations in relation to the selection of the therapeutic class of the antiemetic, dose, route of administration, dosage regimen and duration of treatment, with the prophylaxis expected for the acute and delayed phases being evaluated. Results: Were included 87 patients, 38 and 49 of whom used chemotherapy drugs with high and moderate emetogenic potential, respectively. In the prescriptions containing highly emetogenic chemotherapeutic agents, the antiemetic therapy recommended for acute phase prophylaxis was incorrectly prescribed for 9 patients (23.7%), and the problem encountered was dexamethasone underdose (16.7%). In the delayed phase, problems were identified in the prescriptions of 35 patients (92.1%), including the prescription of inappropriate medication (57.4%), since the prescription contained ondansetron, not foreseen by the guideline at this stage, and the need for dexamethasone as an additional drug (18.5%). For 22 patients (44.9%) exposed to moderately emetogenic antineoplastic agents, the acute regimen was incorrectly prescribed, and the main problems identified were dexamethasone overdose (21.2%) and the need for dexamethasone as an additional drug (5.0%). Delayed antiemetic prophylaxis was incorrectly prescribed for 45 of them (91.8%), with ondansetron treatment duration longer than recommended (26.2%), need for dexamethasone or ondansetron as an additional medication (23.7%) and therapeutic duplicity (12.5%) the problems encountered. Conclusion: It is suggested the implementation of strategies aimed at increasing adherence to the guideline's recommendations by the prescribers, as well as access to medicines considered essential.

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Section: Resultsmentioning

confidence: 97%

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Lázaro¹,

Carlotto²,

Rotta³

2020

Rev Bras Farm Hosp Serv Saude

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“…A large meta-analysis revealed that the addition of a 5-HT 3 antagonist (dolasetron, granisetron, or ondansetron) to dexamethasone does not significantly improve the antiemetic efficacy of dexamethasone alone. 38 Therefore, use of oral 5-HT 3 antagonists for the prevention of delayed CINV is not recommended.…”

Section: Discussionmentioning

confidence: 99%

Applicability of the National Comprehensive Cancer Network/Multinational Association of Supportive Care in Cancer Guidelines for Prevention and Management of Chemotherapy-Induced Nausea and Vomiting in Southeast Asia: A Consensus Statement

Chan

Abdullah

Ishak

et al. 2017

JGO

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A meeting of regional experts was convened in Manila, Philippines, to develop a resource-stratified chemotherapy-induced nausea and vomiting (CINV) management guideline. In patients treated with highly emetogenic chemotherapy in general clinical settings, triple therapy with a serotonin (5-hydroxytryptamine-3 [5-HT3]) antagonist (preferably palonosetron), dexamethasone, and aprepitant is recommended for acute CINV prevention. In resource-restricted settings, triple therapy is still recommended, although a 5-HT3 antagonist other than palonosetron may be used. In both general and resource-restricted settings, dual therapy with dexamethasone (days 2 to 4) and aprepitant (days 2 to 3) is recommended to prevent delayed CINV. In patients treated with moderately emetogenic chemotherapy, dual therapy with a 5-HT3 antagonist, preferably palonosetron, and dexamethasone is recommended for acute CINV prevention in general settings; any 5-HT3 antagonist can be combined with dexamethasone in resource-restricted environments. In general settings, for the prevention of delayed CINV associated with moderately emetogenic chemotherapy, corticosteroid monotherapy on days 2 and 3 is recommended. If aprepitant is used on day 1, it should be continued on days 2 and 3. Prevention of delayed CINV with corticosteroids is preferred in resource-restricted settings. The expert panel also developed CINV management guidelines for anthracycline plus cyclophosphamide combination schedules, multiday cisplatin, and chemotherapy with low or minimal emetogenic potential, and its recommendations are detailed in this review. Overall, these regional guidelines provide definitive guidance for CINV management in general and resource-restricted settings. These consensus recommendations are anticipated to contribute to collaborative efforts to improve CINV management in Southeast Asia.

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“…A meta-analysis of randomized controlled trials found that adding a 5-HT3 antagonist to dexamethasone did not improve the antiemetic effect of dexamethasone for preventing delayed emesis. 78 Another study found that 5-HT3 antagonists (except palonosetron, which was not studied) were not more effective than prochlorperazine for preventing delayed emesis. 17 Intravenous palonosetron seems to be effective for preventing both delayed and acute emesis.…”

Section: Serotonin (5-ht3) Receptor Antagonistsmentioning

confidence: 99%

Antiemesis

Ettinger¹,

Armstrong²,

Barbour³

et al. 2012

J Natl Compr Canc Netw

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Do 5-hydroxytryptamine₃ receptor antagonists (5-HT₃) improve the antiemetic effect of dexamethasone for preventing delayed chemotherapy-induced nausea and vomiting (CINV)? A meta-analysis of randomized controlled trials

Cited by 7 publications

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Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Applicability of the National Comprehensive Cancer Network/Multinational Association of Supportive Care in Cancer Guidelines for Prevention and Management of Chemotherapy-Induced Nausea and Vomiting in Southeast Asia: A Consensus Statement

Antiemesis

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Do 5-hydroxytryptamine3 receptor antagonists (5-HT3) improve the antiemetic effect of dexamethasone for preventing delayed chemotherapy-induced nausea and vomiting (CINV)? A meta-analysis of randomized controlled trials

Cited by 7 publications

References 0 publications

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Applicability of the National Comprehensive Cancer Network/Multinational Association of Supportive Care in Cancer Guidelines for Prevention and Management of Chemotherapy-Induced Nausea and Vomiting in Southeast Asia: A Consensus Statement

Antiemesis

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Do 5-hydroxytryptamine₃ receptor antagonists (5-HT₃) improve the antiemetic effect of dexamethasone for preventing delayed chemotherapy-induced nausea and vomiting (CINV)? A meta-analysis of randomized controlled trials