Department of Oncology, Mayo Clinic, Rochester, MN, USA.
Department of Oncology, Mayo Clinic, Rochester, MN, USA; Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, MN, USA.
Ann Palliat Med. 2022 Jul;11(7):2314-2318. doi: 10.21037/apm-22-159. Epub 2022 Apr 24.
Several case reports suggest that olanzapine palliates hiccups. To our knowledge, however, no larger scale studies have confirmed that olanzapine prevents or palliatives hiccups. Hence, the current study sought to substantiate the conclusions from these earlier case reports.
This multi-site single institution study focused on cisplatin-treated cancer patients because this chemotherapy agent is associated with hiccups and because olanzapine is often used as an antiemetic with this agent. Relevant data were extracted from medical records. Hiccup incidence shortly after chemotherapy was compared between olanzapine exposed and non-exposed patients. Other relevant variables were also assessed descriptively in an exploratory manner.
A total of 338 patients were studied. One hundred forty-one had received olanzapine and 197 had not. Twenty-one (6%) developed hiccups. Eleven (8%) of these patients with hiccups had received olanzapine, and 10 (5%) had not [odds ratio (OR): 1.58; 95% confidence interval (CI): 0.65-3.83; P=0.31]. Of note, hiccups were more often observed in men 17 of 188 (9%) than in women 4 of 150 (3%) (OR: 3.64; 95% CI: 1.20-11.02; P=0.01).
Despite previous case reports and despite the relatively low incidence of hiccups in this study, it does not appear olanzapine prevents or palliates hiccups. The study of other promising agents is warranted. Furthermore, this study invites caution in relying on single case reports in making clinical decisions.
有几项病例报告表明奥氮平可缓解呃逆。然而，据我们所知，尚无更大规模的研究证实奥氮平可预防或缓解呃逆。因此，本研究旨在证实这些早期病例报告的结论。
这项多地点单机构研究主要针对接受顺铂治疗的癌症患者，因为这种化疗药物会引起呃逆，而且奥氮平通常与这种药物一起用于止吐。从病历中提取相关数据。比较接受奥氮平暴露和未暴露的患者在化疗后不久呃逆的发生率。还以探索性方式描述了其他相关变量。
共研究了 338 例患者。141 例接受了奥氮平，197 例未接受。21 例（6%）出现呃逆。其中 11 例（8%）接受奥氮平的患者出现呃逆，10 例（5%）未接受奥氮平的患者出现呃逆[比值比（OR）：1.58；95%置信区间（CI）：0.65-3.83；P=0.31]。值得注意的是，188 例男性中有 17 例（9%）出现呃逆，而 150 例女性中有 4 例（3%）出现呃逆（OR：3.64；95%CI：1.20-11.02；P=0.01）。
尽管有先前的病例报告，而且本研究中呃逆的发生率相对较低，但奥氮平似乎不能预防或缓解呃逆。有必要研究其他有前途的药物。此外，本研究提请谨慎依赖单一病例报告来做出临床决策。
