TABLE 5.
Comparative Efficacy of Antiemetics Versus Placebo in Randomized Controlled Trials
| Antiemetic (class) | Background Antiemetic Regimen | Chemotherapy Emetogenicity | Setting | Sample Size | Duration of Follow-Up | Rate of CR (experimental arm), % | Rate of CR (placebo arm), % | Absolute Improvement in CR, % | Relative Improvement in CR | P | References |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cannabinoid | |||||||||||
| Dronabinol | Nil | Moderate/high | Refractory (91%) | 22 | 0-24 h | 33 | 0 | 33 | (10) | <.001 | Sallan, 197521 |
| Dronabinol | Nil | Moderate | Naïve | 116 | 0-24 h | 42 | 19 | 23 | 1.2 | .05 | Frytak, 197922 |
| Nabilone | UK | Moderate/high | Various | 228 | 0-24 h | 35 | 11 | 24 | 2.2 | <.001 | Wada, 198223 |
| THC:CBD | D, 5HT3 |
Moderate | Refractory | 16 | 0-120 h | 71 | 22 | 49 | 3.2 | NS | Duran, 201012 |
| THC:CBD | D, 5HT3, NK1, +/– O |
Moderate/high | Refractory | 147 | 0-120 h | 24 | 8 | 16 | 3.0 | .01 | This paper |
| 5-HT3 antagonist | Nil relevant trials identified | ||||||||||
| NK-1 inhibitor | |||||||||||
| Aprepitant | D, 5HT3 |
Moderate/high | Naïve | 848 | 0-120 h | 69 | 56 | 13 | 1.2 | <.001 | Rapoport, 200924 |
| Olanzapine | |||||||||||
| Olanzapine | D, 5HT3, NK1 |
High | Naïve | 380 | 0-120 h | 37 | 22 | 15 | 1.7 | .02 | Navari, 201625 |
| Olanzapine | D, 5HT3, NK1 |
High | Naïve | 710 | 0-120 h | 78 | 64 | 14 | 1.2 | <.001 | Hashimoto, 201926 |
Abbreviations: 5-HT3, 5-hydroxytryptamine; CBD, cannabidiol; CR, complete response; D, dexamethasone; h, hours; NK-1, neurokinin-1; NS, not significant; O, olanzapine; THC, tetrahydrocannabinol.