Table 3.
Statistically significant results of network meta-analysis for all time periods of drug administration
| All ages | Children only | |||||
|---|---|---|---|---|---|---|
| Treatment comparison | No. of studies | MA estimate: OR (95 % CI) * | NMA estimate: OR (95 % CI) | No. of studies | MA estimate: OR (95 % CI) * | NMA estimate: OR (95 % CI) |
| Vomiting | 238 RCTs and 12,781 patients | 46 RCTs and 1,830 patients | ||||
| Ondansetron vs. placebo | 146 | 0.35 (0.32–0.39) | 0.36 (0.33–0.40) | 34 | 0.30 (0.24–0.38) | 0.30 (0.24–0.38) |
| Granisetron vs. placebo | 27 | 0.24 (0.16–0.34) | 0.26 (0.21–0.34) | 4 | 0.21 (0.08–0.56) | 0.23 (0.12–0.48) |
| Dolasetron vs. placebo | 7 | 0.42 (0.21–0.83) | 0.44 (0.30–0.63) | 3 | 0.41 (0.23–0.75) | 0.39 (0.19–0.78) |
| Tropisetron vs. placebo | 15 | 0.32 (0.22–0.48) | 0.32 (0.23–0.43) | 3 | 0.18 (0.09–0.36) | 0.18 (0.08–0.41) |
| Ondansetron + DEX vs. placebo | 12 | 0.16 (0.09–0.27) | 0.16 (0.12–0.23) | 5 | 0.06 (0.03–0.17) | 0.07 (0.03–0.15) |
| Palonosetron vs. placebo | 4 | 0.53 (0.38–0.73) | 0.38 (0.24–0.60) | NA | NA | NA |
| Ramosetron vs. placebo | 5 | 0.42 (0.26–0.68) | 0.28 (0.18–0.43) | NA | NA | NA |
| Ondansetron + DROP vs. placebo | 2 | 0.15 (0.07–0.31) | 0.14 (0.08–0.26) | 1 | 0.13 (0.05–0.33) | 0.11 (0.04–0.33) |
| Ondansetron + METO vs. placebo | 2 | 0.16 (0.06–0.43) | 0.15 (0.06–0.42) | 2 | 0.16 (0.06–0.43) | 0.18 (0.06–0.53) |
| Granisetron + DEX vs. placebo | 5 | 0.16 (0.08–0.31) | 0.15 (0.09–0.24) | 2 | 0.08 (0.03–0.27) | 0.09 (0.02–0.31) |
| Dolasetron + DEX vs. placebo | 1 | 0.06 (0.01–0.30) | 0.18 (0.06–0.49) | NA | NA | NA |
| Dolasetron + DROP vs. placebo | 1 | 0.16 (0.07–0.35) | 0.19 (0.07–0.52) | NA | NA | NA |
| Granisetron + DROP vs. placebo | 2 | 0.30 (0.05–1.66) | 0.31 (0.11–0.82) | NA | NA | NA |
| Granisetron vs. ondansetron | 12 | 0.52 (0.34–0.81) | 0.73 (0.56–0.94) | NA | NA | 0.78 (0.37–1.63) |
| Ondansetron + DEX vs. ondansetron | 15 | 0.50 (0.33–0.75) | 0.46 (0.33–0.63) | 3 | 0.24 (0.12–0.47) | 0.23 (0.11–0.49) |
| Ondansetron + DROP vs. ondansetron | 5 | 0.43 (0.24–0.78) | 0.39 (0.21–0.71) | 1 | 0.31 (0.12–0.77) | 0.37 (0.13–1.09) |
| Granisetron + DEX vs. ondansetron | NA | NA | 0.41 (0.25–0.67) | NA | NA | 0.28 (0.08–1.04) |
| Dolasetron vs. granisetron | NA | NA | 1.66 (1.07–2.57) | NA | NA | 1.65 (0.61–4.47) |
| Ondansetron + DEX vs. granisetron | NA | NA | 0.63 (0.42–0.94) | NA | NA | 0.30 (0.11–0.83) |
| Granisetron + DEX vs. granisetron | 7 | 0.39 (0.20–0.77) | 0.57 (0.35–0.92) | 1 | 0.14 (0.02–1.23) | 0.36 (0.09–1.50) |
| Ondansetron + DEX vs. dolasetron | NA | NA | 0.38 (0.23–0.62) | NA | NA | 0.18 (0.07–0.50) |
| Ondansetron + DROP vs. dolasetron | NA | NA | 0.32 (0.16–0.65) | NA | NA | 0.29 (0.08–1.04) |
| Granisetron + DEX vs. dolasetron | NA | NA | 0.34 (0.19–0.63) | NA | NA | 0.22 (0.05–0.95) |
| Ondansetron + DEX vs. tropisetron | NA | NA | 0.52 (0.33–0.82) | NA | NA | 0.40 (0.13–1.22) |
| Ondansetron + DROP vs. tropisetron | NA | NA | 0.45 (0.23–0.88) | NA | NA | 0.64 (0.16–2.48) |
| Granisetron + DEX vs. tropisetron | NA | NA | 0.47 (0.26–0.84) | NA | NA | 0.48 (0.10–2.25) |
| Palonosetron vs. ondansetron + DEX | NA | NA | 2.32 (1.33–4.07) | NA | NA | NA |
| Ramosetron vs. ondansetron + DEX | NA | NA | 1.71 (1.01–2.90) | NA | NA | NA |
| Palonosetron + DEX vs. ondansetron + DEX | NA | NA | 8.68 (1.19–63.20) | NA | NA | NA |
| Ondansetron + DROP vs. palonosetron | NA | NA | 0.37 (0.17–0.78) | NA | NA | NA |
| Granisetron + DEX vs. palonosetron | NA | NA | 0.39 (0.20–0.75) | NA | NA | NA |
| Palonosetron + DEX vs. ondansetron + DROP | NA | NA | 10.13 (1.31–78.58) | NA | NA | NA |
| Palonosetron + DEX vs. ondansetron + METO | NA | NA | 9.38 (1.03–85.06) | NA | NA | NA |
| Palonosetron + DEX vs. granisetron + DEX | NA | NA | 9.60 (1.28–72.03) | NA | NA | NA |
| Nausea | 195 RCTs and 24,230 patients | 11 RCTs and 1,326 patients | ||||
| Ondansetron vs. placebo | 121 | 0.46 (0.40–0.52) | 0.46 (0.41–0.52) | 10 | 0.44 (0.29–0.68) | 0.45 (0.30–0.66) |
| Granisetron vs. placebo | 21 | 0.35 (0.23–0.52) | 0.35 (0.26–0.47) | NA | NA | NA |
| Dolasetron vs. placebo | 9 | 0.59 (0.48–0.73) | 0.60 (0.43–0.86) | 1 | 0.29 (0.11–0.73) | 0.26 (0.09–0.74) |
| Tropisetron vs. placebo | 15 | 0.51 (0.40–0.66) | 0.48 (0.35–0.65) | NA | NA | NA |
| Ondansetron + DEX vs. placebo | 8 | 0.21 (0.14–0.34) | 0.28 (0.19–0.41) | 2 | 0.21 (0.08–0.57) | 0.22 (0.08–0.61) |
| Palonosetron vs. placebo | 3 | 0.48 (0.33–0.68) | 0.30 (0.17–0.53) | NA | NA | NA |
| Ramosetron vs. placebo | 5 | 0.35 (0.18–0.68) | 0.32 (0.22–0.47) | NA | NA | NA |
| Ondansetron + DROP vs. placebo | 2 | 0.31 (0.06–1.55) | 0.26 (0.14–0.49) | 1 | 0.07 (0.00–1.26) | 0.07 (0.00–1.38) |
| Granisetron + DEX vs. placebo | 4 | 0.21 (0.11–0.39) | 0.20 (0.12–0.34) | 1 | 0.09 (0.02–0.49) | 0.10 (0.02–0.53) |
| Dolasetron + DEX vs. placebo | 1 | 0.28 (0.05–1.53) | 0.21 (0.07–0.61) | NA | NA | NA |
| Dolasetron + DROP vs. placebo | 1 | 0.17 (0.08–0.36) | 0.19 (0.07–0.54) | NA | NA | NA |
| Granisetron + DROP vs. placebo | 2 | 0.22 (0.08–0.61) | 0.21 (0.07–0.62) | NA | NA | NA |
| Ondansetron + DEX vs. ondansetron | 14 | 0.68 (0.48–0.96) | 0.61 (0.42–0.89) | 1 | 0.53 (0.11–2.60) | 0.48 (0.16–1.43) |
| Granisetron + DEX vs. ondansetron | NA | NA | 0.43 (0.25–0.73) | NA | NA | 0.21 (0.04–1.23) |
| Dolasetron vs. granisetron | NA | NA | 1.73 (1.10–2.72) | NA | NA | NA |
| Granisetron + DEX vs. granisetron | 6 | 0.59 (0.39–0.88) | 0.56 (0.33–0.95) | NA | NA | NA |
| Ondansetron + DEX vs. dolasetron | NA | NA | 0.47 (0.28–0.78) | NA | NA | 0.81 (0.19–3.50) |
| Palonosetron vs. dolasetron | NA | NA | 0.50 (0.26–0.97) | NA | NA | NA |
| Ramosetron vs. dolasetron | NA | NA | 0.53 (0.31–0.88) | NA | NA | NA |
| Ondansetron + DROP vs. dolasetron | NA | NA | 0.44 (0.21–0.89) | NA | NA | 0.28 (0.01–6.17) |
| Granisetron + DEX vs. dolasetron | NA | NA | 0.33 (0.17–0.62) | NA | NA | 0.36 (0.05–2.66) |
| Dolasetron + DEX vs. dolasetron | 2 | 0.33 (0.15–0.72) | 0.35 (0.13–0.97) | NA | NA | NA |
| Dolasetron + DROP vs. dolasetron | 1 | 0.35 (0.17–0.73) | 0.32 (0.11–0.89) | NA | NA | NA |
| Ondansetron + DEX vs. tropisetron | NA | NA | 0.59 (0.36–0.95) | NA | NA | NA |
| Granisetron + DEX vs. tropisetron | NA | NA | 0.41 (0.22–0.76) | NA | NA | NA |
| Postoperative nausea and vomiting | 125 RCTs and 16,667 patients | 14 RCTs and 2,394 patients | ||||
| Ondansetron vs. placebo | 89 | 0.30 (0.26–0.35) | 0.31 (0.27–0.36) | 11 | 0.33 (0.18–0.60) | 0.34 (0.19–0.62) |
| Granisetron vs. placebo | 16 | 0.23 (0.14–0.37) | 0.23 (0.16–0.32) | 2 | 0.54 (0.26–1.12) | 0.32 (0.08–1.23) |
| Dolasetron vs. placebo | 5 | 0.27 (0.14–0.52) | 0.25 (0.14–0.43) | NA | NA | NA |
| Tropisetron vs. placebo | 8 | 0.39 (0.28–0.53) | 0.36 (0.24–0.54) | NA | NA | NA |
| Ondansetron + DEX vs. placebo | 8 | 0.12 (0.07–0.20) | 0.15 (0.10–0.22) | 1 | 0.20 (0.06–0.66) | 0.27 (0.04–1.61) |
| Palonosetron vs. placebo | NA | NA | 0.11 (0.03–0.40) | NA | NA | NA |
| Ramosetron vs. placebo | 4 | 0.30 (0.15–0.59) | 0.26 (0.16–0.41) | NA | NA | NA |
| Ondansetron + DROP vs. placebo | 2 | 0.13 (0.05–0.34) | 0.11 (0.05–0.24) | 1 | 0.12 (0.04–0.34) | 0.12 (0.02–0.71) |
| Granisetron + DEX vs. placebo | 4 | 0.06 (0.02–0.17) | 0.09 (0.05–0.16) | NA | NA | NA |
| Palonosetron + DEX vs. placebo | NA | NA | 0.12 (0.02–0.64) | NA | NA | NA |
| Dolasetron + DROP vs. placebo | 1 | 0.17 (0.08–0.36) | 0.12 (0.04–0.35) | NA | NA | NA |
| Granisetron + DROP vs. placebo | 2 | 0.17 (0.07–0.38) | 0.16 (0.06–0.40) | NA | NA | NA |
| Ondansetron + DEX vs. ondansetron | 11 | 0.48 (0.33–0.72) | 0.46 (0.31–0.69) | 1 | 1.00 (0.36–2.75) | 0.78 (0.13–4.65) |
| Ondansetron + DROP vs. ondansetron | 3 | 0.39 (0.20–0.75) | 0.35 (0.16–0.77) | NA | NA | NA |
| Granisetron + DEX vs. ondansetron | 1 | 0.22 (0.04–1.21) | 0.30 (0.17–0.53) | NA | NA | NA |
| Granisetron + DEX vs. granisetron | 8 | 0.48 (0.29–0.77) | 0.41 (0.24–0.69) | NA | NA | NA |
| Granisetron + DEX vs. dolasetron | NA | NA | 0.37 (0.17–0.82) | NA | NA | NA |
| Ondansetron + DEX vs. tropisetron | NA | NA | 0.41 (0.23–0.73) | NA | NA | NA |
| Ondansetron + DROP vs. tropisetron | NA | NA | 0.31 (0.13–0.75) | NA | NA | NA |
| Granisetron + DEX vs. tropisetron | NA | NA | 0.26 (0.13–0.52) | NA | NA | NA |
| Granisetron + DEX vs. ramosetron | NA | NA | 0.36 (0.18–0.75) | NA | NA | NA |
* Meta-analysis was not conducted for treatment comparisons where only 1 trial was included. In that situation, the direct estimate was obtained from the single trial
CI confidence interval, DEX dexamethasone, DROP droperidol (intravenous), MA meta-analysis, METO metoclopramide (intravenous), NA not applicable, NMA network meta-analysis, OR odds ratio