3885 - Olanzapine Combined with 5-HT3 RA Plus Dexamethasone for Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in High and Moderate Emetogenic Chemotherapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

We conducted a review to evaluate the efficacy and adverse events (AEs) of olanzapine combined with 5-hydroxytryptamine type 3 (5-HT3) RA plus dexamethasone compared with 5-HT3 RA plus dexamethasone for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in high and moderate emetogenic chemotherapy based on randomized controlled trials (RCTs).

Methods

PubMed, Web of Science, The Cochrane library, and EMBASE, China National Knowledge Infrastructure (CNKI), WanFang Database, China Biomedical Literature database (CBM), and Chinese Science and Technology Periodical Database (VIP) (inception to April 2019) were searched to recognize relevant articles. Relative risk (RR) with 95% confidence intervals (CIs) for CINV and AEs were all extracted.

Results

11 studies with 1107 cancer patients were involved in this review. The pooled RR of acute CINV (RR = 0.60, 95%CI: 0.48–0.75, Z=-4.57, P < 0.01) and delayed CINV (RR = 0.50, 95%CI: 0.38-0.66, Z=-4.87, P < 0.01) were significant decreased. While only CINV III and CINV IV were significant deceased in olanzapine groups. Subgroup analysis indicated that there was no significant difference between 5mg and 10mg for olanzapine. Moreover, the occurrence of insomnia was statistically decreased in olanzapine group.

Conclusions

Olanzapine significant decreased the occurrence of moderate-severe CINV (CINV III and IV) and insomnia for the prevention and treatment of CINV in high and moderate emetogenic chemotherapy. Compared with 10mg per day, 5mg oral may be more appropriate for cancer patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.