Role of olanzapine in chemotherapy-induced nausea and vomiting on platinum-based chemotherapy patients: a randomized controlled study

Mukhopadhyay, Sandip; Kwatra, Gagandeep; K, Pamela Alice; Badyal, Dinesh

doi:10.1007/s00520-016-3386-9

Cited by 35 publications

(63 citation statements)

References 41 publications

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“…The age range of the participants included in RCTS was 18-8920-24,26,29,31,32 and not reported in three of the trials 25,27,28. One of the trials reported age in median (SD) 30. Seven of the trails reported that either 5-HT 3 receptor antagonist and/or dexamethasone with olanzapine compared with the same regimen without olanzapine24-30 and 6 of trials reported that olanzapine with NK-1 receptor antagonists (either aprepitant or fosaprepitant) containing regimen 20-23,31,32.…”

Section: Resultsmentioning

confidence: 99%

“…Seven of the trails reported that either 5-HT 3 receptor antagonist and/or dexamethasone with olanzapine compared with the same regimen without olanzapine24-30 and 6 of trials reported that olanzapine with NK-1 receptor antagonists (either aprepitant or fosaprepitant) containing regimen 20-23,31,32. Eleven trials reported olanzapine administered at a dose in 10 mg/day orally20-26,28,30-32, whereas two trials reported olanzapine administered in a 5 mg/day orally 27,29. Nine of the trials reported participants receiving HEC20-23,25,26,30,31,32 and four studies included patients receiving combination of MEC/HEC 24,27-29.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven trials reported olanzapine administered at a dose in 10 mg/day orally20-26,28,30-32, whereas two trials reported olanzapine administered in a 5 mg/day orally 27,29. Nine of the trials reported participants receiving HEC20-23,25,26,30,31,32 and four studies included patients receiving combination of MEC/HEC 24,27-29. No study reported patients receiving only MEC.…”

Section: Resultsmentioning

confidence: 99%

“…Two of the studies were double-blinded RCTs20,32, three were single blinded and the rest were unblinded. Finally, 8 studies reported participants of Asian background; two from India30,31, one from Japan29 and five from China 24-28. Five of the studies reported that the patients included where from USA 20-23,32…”

Section: Resultsmentioning

confidence: 99%

“…Many randomized controlled trials (RCTs) have been then conducted to confirm the effect of addition of olanzapine to the standard antiemetic regimen 20,21,22,23,24,25,26,27,28,29,30,31,32. A previous meta-analysis conducted by Wang et al33 revealed that the rate of patients achieving total control of nausea and vomiting was significantly higher in the olanzapine group.…”

Section: Introductionmentioning

confidence: 99%

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Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

Chelkeba¹,

Gidey²,

Mamo³

et al. 2017

Pharm Pract (Granada)

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Background:Chemotherapy induced nausea and vomiting (CINV) remains the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC).Objective:Therefore, this meta-analysis was conducted to evaluate the efficacy of olanzapine containing regimen in preventing acute, delayed and overall phases of CINV.Methods:PubMed, EBSCO, and Cochrane central register of controlled trials electronic databases were searched to identify RCTs that compared the effects of olanzapine with non-olanzapine regimen in preventing CINV. Randomized clinical trials (RCTs) that compared olanzapine containing regimen with non-olanzapine regimen were included. The primary outcomes were the percentage of patients achieving no vomiting or no nausea in acute, delayed and overall phases.Results:13 RCTs that enrolled 1686 participants were included in this meta-analysis. 852 patients were assigned to olanzapine and 834 patients were assigned to non-olanzapine regimen (other standard antiemetic regimen). The percentages of no emesis achieved were 87.5%, 76.2%, 73.6% in olanzapine versus 76.7%, 61.8%, and 56.4% in non-olanzapine regimen in acute, delayed and overall phases, respectively. The percentages of no nausea were 82%, 64.3%, 61.6% in olanzapine group versus 71.3%, 41.8%, and 40.6% in non-olanzapine group in acute, delayed and overall phases, respectively. In general, olanzapine containing regimen achieved statistical superiority to non-olanzapine regimen in no vomiting endpoint in acute phase (OR 2.16; 95%CI 1.60 to 2.91, p<0.00001; I-square=5%; p=0.40), delayed phase (OR 2.28; 95%CI 1.1.46 to 3.54, p=0.0003; I-square=65%; p=0.001) and overall phase (OR 2.48; 95%CI 1.59 to 3.86, p<0.0001; I-square=69%; p< 0.0001).Conclusion:The current meta-analysis showed that olanzapine was statistically and clinically superior to non-olanzapine regimen in preventing CINV in most domains of the parameters.

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