Ondansetron versus metoclopramide for managing hyperemesis gravidarum: A systematic review and meta-analysis of randomized controlled trials

Abstract

This investigation examined the efficacy of ondansetron (intervention) versus metoclopramide (control) in managing parturient females with hyperemesis gravidarum (HG), by pooling data from randomized controlled trials (RCTs) using a meta-analysis approach. From inception until January 2022, five information sources were screened: Cochrane Central Register of Controlled Trials, Google Scholar, Scopus, PubMed and Web of Science. Quality assessment was done through the Cochrane Risk of Bias (version 2) assessment tool. The mean difference (MD) with 95% confidence interval (CI) was used to summarize the continuous data in a fixed- or random-effects model, depending on the extent of between-study heterogeneity. Five RCTs were included, comprising a total of 695 patients (355 and 340 females were assigned to ondansetron and metoclopramide, respectively). Four RCTs had an overall “low” risk of bias, whereas one RCT had an overall “some concerns” due to lack of sufficient information about randomization. There was no significant difference between both groups regarding the pregnancy-unique quantification of emesis and nausea score [MD=0.23, 95% CI (-0.42, 0.88), p=0.49], length of hospital stay [MD=-0.17 days, 95% CI (-0.35, 0.02), p=0.08], the number of doses of drug received [MD=0.45, 95% CI (-0.08, 0.98), p=0.10], and duration of intravenous fluids [MD=-1.73 hours, 95% CI (-5.79, 2.33), p=0.40]. Among parturient females with HG, there was no substantial difference in efficacy between both agents. Nevertheless, ondansetron is favored over metoclopramide in view of its trending therapeutic efficacy and better safety profile.

Comparative Analysis of Oral Ondansetron, Metoclopramide, and Domperidone for Managing Vomiting in Children With Acute Gastroenteritis

“…By reducing emesis, ondansetron may also promote oral fluid intake, potentially decreasing the requirement for hospitalization and intravenous rehydration [24]. Previous studies administered ondansetron, domperidone, and metoclopramide orally, with the oral disintegrating form of ondansetron offering a simpler and less-invasive administration method, particularly advantageous for vomiting children and those receiving outpatient care [9,16,[25][26][27][28][29][30]. Furthermore, our study also delved into the safety profile of these antiemetic medications.…”

Efektivitas Pemberian Kombinasi Jahe Dan Buah Tin Terhadap Emesis Gravidarum Pada Ibu Hamil Trimester 1

“…Ondansetron adalah antagonis reseptor serotonin yang efektif untuk mengobati Emesis Gravidarum (Albazee et al, 2022). Menurut Penelitian (Albazee et al, 2022) yang membandingkan ondansetron dengan metoklopramid untuk manajemen terapi mual muntah pada Ibu hamil dengan menggunakan analisa systematic review dan Randomized Controlled Trial hasil menunjukkan ondansetron lebih baik dibandingkan dengan metoklopramid dengan dilihat dari kemanjuran terapi.…”

“…Ondansetron adalah antagonis reseptor serotonin yang efektif untuk mengobati Emesis Gravidarum (Albazee et al, 2022). Menurut Penelitian (Albazee et al, 2022) yang membandingkan ondansetron dengan metoklopramid untuk manajemen terapi mual muntah pada Ibu hamil dengan menggunakan analisa systematic review dan Randomized Controlled Trial hasil menunjukkan ondansetron lebih baik dibandingkan dengan metoklopramid dengan dilihat dari kemanjuran terapi. Hal tersebut disokong pula oleh penelitian yang dilaksanakan (Moradiha et al, 2022) dengan analisis Randomized Controlled Trial dengan peneliti menggunakan intervensi ondansetron dengan dosis 4 mg dengan metoklopramid dengan dosis 10 mg menunjukkan bahwa ondansetron lebih efektif dibandingkan dengan metoklopramid dalam terapi Emesis Gravidarum pada Ibu hamil.…”

The modern aspects of the optimal therapeutic strategy of hyperemesis gravidarum

“…Нещодавно оновлений мета-аналіз 12 порівняльних досліджень (2022) продемонстрував, що вплив ондансетрону протягом І триместра корелює з високим ризиком дефекту міжшлуночкової перегородки (6 досліджень, відношення шансів=1,11) та «вовчої пащі» (5 досліджень, відношення шансів =1,48). Однак не було виявлено жодного суттєвого зв'язку між різними вадами серця та черепно-лицьовими аномаліями [9].…”