Efficacy, safety and effectiveness of ondansetron compared to other serotonin-3 receptor antagonists (5-HT₃RAs) used to control chemotherapy-induced nausea and vomiting: systematic review and meta-analysis

ABSTRACT

Introduction: Chemotherapy-induced nausea and vomiting are adverse effects responsible for worsening quality of life in cancer patients. To assess the efficacy, safety and effectiveness of serotonin receptor antagonist in cancer patients undergoing chemotherapy, comparing ondansetron with granisetron, dolasetron, tropisetron and palonosetron.

Areas covered: Systematic review and meta-analysis. The data were collected using CINAHL; CENTRAL; MEDLINE/PubMed; and LILACS databases; grey literature; and manual search. The methodological quality was assessed using the modified Jadad scale; Cochrane Collaboration’s tool for assessing risk of bias in randomized clinical trials and the Newcastle-Ottawa Scale for observational studies. The search was completed in November, 2015. 26 studies were included in the meta-analysis. Ondansetron exhibited similar efficacy than granisetron and tropisetron, as well as greater efficacy than dolasetron for acute vomiting. Palonosetron exhibited greater efficacy than ondansetron for delayed nausea and acute and delayed vomiting. The comparison of granisetron with ondansetron in the cohort studies showed no difference.

Expert commentary: In this review, palonosetron had increased efficiency compared with ondansetron, except in the subgroup analysis and acute nausea. Few cohort studies have been published addressing this topic.

KEYWORDS:

• Chemotherapy
• nausea
• vomiting
• pharmacology
• symptom management
• systematic review
• meta-analysis
• 5-HT₃ antagonist serotonin
• ondansetron and granisetron

Declaration of interest

The authors were supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq, Brazil. (National Council for Scientific and Technological Development). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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