Department of Pharmacy, Weifang People's Hospital, Weifang, China.
Medicine (Baltimore). 2023 Nov 24;102(47):e35952. doi: 10.1097/MD.0000000000035952.
Most cancer patients suffer from the pain of chemotherapy-induced nausea and vomiting (CINV). This meta-analysis was performed to evaluate the efficacy and safety of a regimen consisting of aprepitant, dexamethasone, and 5-HT3 receptor antagonists in the prevention and treatment of CINV.
A systematic literature search was conducted across multiple databases, including PubMed, EMbase, Cochrane Library, MEDLINE, CENTRAL, HEED, CNKI, Wanfang, and VIP, to identify randomized controlled trials (RCTs) investigating the use of triple therapy (aprepitant, 5-HT3 receptor antagonist, and dexamethasone) to prevent and treat CINV. Meta-analysis was performed using RevMan 5.4 and Stata17 software, employing either a fixed-effect or random-effect model based on statistical heterogeneity.
A meta-analysis of 23 randomized controlled trials (RCTs) involving 7956 patients was conducted. Efficacy: Results showed significantly improved complete responses (CRs) for CINV in the test group versus the control group in the overall, acute, and delayed phases. Furthermore, in the test group, substantial alleviation of nausea symptoms was observed in the delayed and overall phases but not in the acute phase. Safety: There was no statistically significant difference in the incidence of febrile neutropenia, diarrhea, anorexia, and headache between the 2 groups. The incidence of fatigue and hiccups in the test group was higher than that in the control group; however, the incidence of constipation was significantly lower.
Aprepitant-containing triple therapy is highly effective in the prevention and treatment of CINV, with reliable medication safety.
大多数癌症患者都遭受化疗引起的恶心和呕吐（CINV）的痛苦。本荟萃分析旨在评估阿瑞匹坦、地塞米松和 5-HT3 受体拮抗剂三联疗法预防和治疗 CINV 的疗效和安全性。
通过对多个数据库（包括 PubMed、EMbase、Cochrane Library、MEDLINE、CENTRAL、HEED、CNKI、万方和 VIP）进行系统文献检索，确定了评估三联疗法（阿瑞匹坦、5-HT3 受体拮抗剂和地塞米松）预防和治疗 CINV 的随机对照试验（RCT）。使用 RevMan 5.4 和 Stata17 软件进行荟萃分析，根据统计异质性采用固定效应或随机效应模型。
对 23 项涉及 7956 例患者的随机对照试验进行荟萃分析。疗效：结果显示，试验组在总体、急性期和延迟期的 CINV 完全缓解（CR）率明显优于对照组。此外，在试验组中，延迟期和总体期的恶心症状得到了明显缓解，但在急性期则没有。安全性：两组之间在发热性中性粒细胞减少症、腹泻、厌食症和头痛的发生率方面没有统计学差异。试验组的疲劳和呃逆发生率高于对照组，但便秘发生率显著降低。
含阿瑞匹坦的三联疗法在预防和治疗 CINV 方面非常有效，且具有可靠的药物安全性。
