Song, H.J., Seo, H.J., & Son, H. (2016). Comparative effectiveness of ramosetron for preventing chemotherapy-induced nausea and vomiting: A systematic review and meta-analysis. European Journal of Clinical Pharmacology, 72, 1289–1301. 

DOI Link

Purpose

STUDY PURPOSE: To evaluate the effectiveness and safety of ramosetron for chemotherapy-induced nausea and vomiting (CINV) through a systematic review of randomized, controlled trials (RCTs)

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: CENTRAL, Ovid MEDLINE, Ovid EMBASE, KoreaMed, KISS, KMbase, DBpia
 
INCLUSION CRITERIA: RCTs comparing ramosetron treatment and other 5-HT3RAs to prevent CINV; studies reporting at least one clinical outcome about efficacy were included.
 
EXCLUSION CRITERIA: Studies not using ramosetron, studies not using chemotherapy, non-RCTs, and non-original articles were excluded.

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 410
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Two reviewers independently extracted the data using a protocol specified by clinical experts and methodologists.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 16
  • TOTAL PATIENTS INCLUDED IN REVIEW = 2,083
  • SAMPLE RANGE ACROSS STUDIES: Variety of ages and diagnoses
  • KEY SAMPLE CHARACTERISTICS: Most cisplatin-based regimens in China, Japan, Taiwan, India, and Korea

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results

In the acute phase, ramosetron significantly reduced nausea and acute vomiting compared to other 5HT3RAs. In the delayed phase, difference in complete response of nausea existed between ramosetron and other 5-HT3RAs. No significant differences existed between common adverse reactions.

Conclusions

The study concluded that ramosetron for CINV may be as effective and as tolerable as other 5-HT3RAs, but more well-designed RCTs are needed to confirm the effect of ramosetron on acute or delayed CINV in patients with cancer.

Limitations

The methodological quality of studies was not high (different dosages, missing data, limited information on MEC or low risk).

Nursing Implications

Ramosetron may be effective for CINV and as tolerable as other 5HT3RAs. More well-designed RCTs are needed to confirm the effect of ramosetron on acute or delayed CINV.

Legacy ID

6379