奥氮平用于化疗引起的恶心和呕吐：系统评价与荟萃分析。
Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis.
作者信息
Chelkeba Legese, Gidey Kidu, Mamo Ayele, Yohannes Berhane, Matso Tsehay, Melaku Tsegaye
机构信息
PhD. Department of clinical Pharmacy, College of Health Sciences, Jimma University. Jimma, (Ethiopia).
MSc. Department of clinical Pharmacy, College of Health Sciences, Jimma University. Jimma, (Ethiopia).
出版信息
Pharm Pract (Granada). 2017 Jan-Mar;15(1):877. doi: 10.18549/PharmPract.2017.01.877. Epub 2017 Mar 15.
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.
背景
化疗引起的恶心和呕吐（CINV）仍然是接受高致吐性化疗（HEC）或中度致吐性化疗（MEC）患者中最令人痛苦的事件。
目的
因此，进行这项荟萃分析以评估含奥氮平方案在预防CINV的急性、延迟和总体阶段的疗效。
方法
检索PubMed、EBSCO和Cochrane对照试验中央注册电子数据库，以识别比较奥氮平与非奥氮平方案预防CINV效果的随机对照试验（RCT）。纳入比较含奥氮平方案与非奥氮平方案的随机临床试验（RCT）。主要结局是在急性、延迟和总体阶段无呕吐或无恶心的患者百分比。
结果
本荟萃分析纳入了13项随机对照试验，共1686名参与者。852名患者被分配到奥氮平组，834名患者被分配到非奥氮平方案组（其他标准止吐方案）。在急性、延迟和总体阶段，奥氮平组无呕吐的百分比分别为87.5%、76.2%、73.6%，而非奥氮平方案组分别为76.7%、61.8%和56.4%。奥氮平组无恶心的百分比在急性、延迟和总体阶段分别为82%、64.3%、61.6%，而非奥氮平组分别为71.3%﹑41.8%和40.6%。总体而言，含奥氮平方案在急性期无呕吐终点方面（比值比2.16；95%可信区间1.60至2.91，p<0.00001；I²=5%；p=0.40）、延迟期（比值比2.28；95%可信区间1.46至3.54，p=0.0003；I²=65%；p=0.001）和总体期（比值比2.48；95%可信区间1.59至3.86，p<0.00）优于非奥氮平方案，差异有统计学意义。
结论
当前的荟萃分析表明，在预防CINV的大多数参数领域，奥氮平在统计学和临床上均优于非奥氮平方案。
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