三联方案防治中高度致吐风险化疗药物致急性恶心呕吐疗效的网状Meta分析

张田; 李婷; 张亚同; 王洋; 金鹏飞

doi:10.6039/j.issn.1001-0408.2024.06.20

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三联方案防治中高度致吐风险化疗药物致急性恶心呕吐疗效的网状Meta分析

循证药学 | 更新时间：2024-04-09

- 三联方案防治中高度致吐风险化疗药物致急性恶心呕吐疗效的网状Meta分析
- Network meta-analysis of triple therapy for the prevention and treatment of acute nausea and vomiting caused by emetogenic chemotherapy drugs with moderate and high risk
- 中国药房 2024年35卷第6期页码：750-757
- 作者机构：
  
  北京医院药学部/国家老年医学中心/中国医学科学院老年医学研究院/北京市药物临床风险与个体化应用评价重点实验室（北京医院），北京　100730
- 作者简介：
  
  主管药师，硕士。研究方向：循证药学。E-mail：15201008872@163.com
  主任药师，博士。研究方向：医院药学、药物分析。 E-mail：j790101@163.com
- 基金信息：
  
  中央高水平医院临床科研专项(BJ-2022-095)
- DOI：10.6039/j.issn.1001-0408.2024.06.20
  中图分类号： R975+.4
- 纸质出版日期：2024-03-30，
  
  收稿日期：2023-08-15，
  
  修回日期：2024-02-26，
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张田,李婷,张亚同等.三联方案防治中高度致吐风险化疗药物致急性恶心呕吐疗效的网状Meta分析 ^Δ[J].中国药房,2024,35(06):750-757.

ZHANG Tian,LI Ting,ZHANG Yatong,et al.Network meta-analysis of triple therapy for the prevention and treatment of acute nausea and vomiting caused by emetogenic chemotherapy drugs with moderate and high risk[J].ZHONGGUO YAOFANG,2024,35(06):750-757.
张田,李婷,张亚同等.三联方案防治中高度致吐风险化疗药物致急性恶心呕吐疗效的网状Meta分析 ^Δ[J].中国药房,2024,35(06):750-757. DOI： 10.6039/j.issn.1001-0408.2024.06.20.

ZHANG Tian,LI Ting,ZHANG Yatong,et al.Network meta-analysis of triple therapy for the prevention and treatment of acute nausea and vomiting caused by emetogenic chemotherapy drugs with moderate and high risk[J].ZHONGGUO YAOFANG,2024,35(06):750-757. DOI： 10.6039/j.issn.1001-0408.2024.06.20.

摘要

目的

评价5-羟色胺3（5-HT

）受体拮抗剂、神经激肽-1（NK-1）受体拮抗剂和地塞米松联用方案（以下简称“三联方案”）防治中高度致吐风险化疗药物致急性恶心呕吐的疗效。

方法

检索PubMed、Embase、Cochrane图书馆、中国期刊全文数据库、万方数据，收集不同三联方案或5-HT

受体拮抗剂联用地塞米松（以下简称“二联方案”）的随机对照试验（RCT），检索时限为建库至2023年5月。筛选文献、提取资料、评价文献质量后，采用Stata 16.0软件进行网状Meta分析。

结果

共纳入59项RCT，共计23 418例患者，涉及15种干预措施。网状Meta分析结果显示，急性恶心呕吐控制率方面，以福沙匹坦+帕洛诺司琼+地塞米松（FPD）疗效最优，其次为福沙匹坦+格拉司琼+地塞米松（FGD）和阿瑞匹坦+雷莫司琼+地塞米松（AMD）；急性恶心控制率方面，以FPD的疗效最优，其次为阿瑞匹坦+帕洛诺司琼+地塞米松（APD）和FGD；急性呕吐控制率方面，以FPD疗效最优，其次为FGD和APD。

结论

福沙匹坦+格拉司琼+地塞米松较其他三联方案或二联方案防治中高度致吐风险化疗药物所致急性恶心呕吐的疗效更好。

Abstract

OBJECTIVE

To evaluate the efficacy of the triple therapy of 5-HT

receptor antagonists， neurokinin-1 receptor antagonists and dexamethasone （referred to as “triple therapy”） in the prevention and treatment of acute nausea and vomiting caused by moderately and highly emetogenic chemotherapy drugs.

METHODS

Retrieved from PubMed， Embase， the Cochrane Library， CNKI and Wanfang data， randomized controlled trials （RCTs） about triple therapy or 5-HT

receptor antagonist combined with dexamethasone （referred to as “dual therapy”） were collected during the inception to May 2023. After literature screening， data extraction and literature evaluation， network meta-analysis was performed by using Stata 16.0 software.

RESULTS

A total of 59 RCTs were included， involving 23 418 patients and 15 interventions. Results of network meta-analysis showed that fosaprepitant + palonosetron + dexamethasone （FPD） was most effective in terms of acute nausea and vomiting control rate， followed by fosaprepitant + granisetron + dexamethasone （FGD） and aprepitant + ramosetron + dexamethasone （AMD）. In terms of acute nausea control rate， FPD was the most effective， followed by aprepitant + palonosetron + dexamethasone （APD） and FGD. In terms of acute vomiting control rate， FPD was the most effective， followed by FGD and APD.

CONCLUSIONS

Fosaprepitant + palonosetron + dexamethasone is better than other triple therapy or dual therapy in preventing acute nausea and vomiting caused by moderately and highly emetogenic chemotherapy drugs.

关键词

5-羟色胺3受体拮抗剂神经激肽-1受体拮抗剂地塞米松恶心呕吐网状Meta分析

Keywords

neurokinin-1 receptor antagonistdexamethasonenausea and vomitingnetwork meta-analysis

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