阿瑞匹坦预防中高度致吐性化疗方案所致恶心呕吐的Meta分析

发布时间：2018-02-10 11:41

本文关键词： 阿瑞匹坦化疗恶心呕吐 Meta分析　出处：《中国新药杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的:评价阿瑞匹坦预防中高度致吐性化疗方案所致恶心、呕吐的疗效及安全性。方法:检索Medline,Cochrane Library,Pubmed,CNKI,CBM,万方和VIP 7个数据库(建库起至2016年10月),纳入以比较阿瑞匹坦与常规止吐药预防化疗相关性恶心呕吐(CINV)为目的的随机对照试验,结局判断指标为急性和/或延迟性呕吐的完全缓解率(CR)、恶心的控制率以及不良反应等。结果:最终纳入18项符合标准的高质量随机对照试验。结果表明:(1)与对照组相比,阿瑞匹坦组急性呕吐CR明显提高(84.5%vs 77.4%,OR=1.60,P0.01),亚组分析显示顺铂方案化疗患者的获益高于卡铂及AC方案化疗者;但2组对急性恶心控制率差异不大(88.6%vs 85.4%,OR=1.41,P=0.02)。(2)阿瑞匹坦能明显提高延迟性呕吐CR:阿瑞匹坦对比5-HT3RA,CR提高了7.8%(62.9%vs 55.1%,OR=1.39,P0.01);阿瑞匹坦对比安慰剂,CR提高了14%(67.4%vs 53.4%,OR=1.85,P0.01);阿瑞匹坦联合地塞米松比单用地塞米松CR提高了17.9%(73.2%vs 55.3%,OR=2.22,P0.01)。(3)阿瑞匹坦联合地塞米松比地塞米松对延迟性恶心控制率提高了9.3%(74.4%vs 65.1%,OR=1.55,P=0.01)。(4)不良反应:阿瑞匹坦组疲劳的发生率高于对照组(P=0.01),而便秘的发生率低于对照组(P=0.03),头痛、腹泻、厌食等发生率2组无明显差异。结论:阿瑞匹坦临床耐受性好,对延迟性呕吐、恶心及急性呕吐改善明显,尤其是顺铂方案化疗患者受益明显,但对急性恶心症状作用不大。临床上仍需进一步观察阿瑞匹坦对不同化疗方案所致CINV的改善情况。
[Abstract]:Objective: to evaluate the effect of aripitan on nausea caused by moderate and high level of emetic chemotherapy. Efficacy and safety of vomiting. Methods: seven databases of Medlinea Cochrane Library Pubmedmedus, Wanfang and VIP were searched (established up to October 2016) and included in a randomized controlled trial aimed at comparing Arepitan with conventional antiemetic drugs in the prevention of chemotherapy-associated nausea and vomiting. The outcome criteria were complete remission rate of acute and / or delayed vomiting, nausea control rate and adverse reactions. Results: 18 high quality randomized controlled trials were included. The CR of acute vomiting in group A was significantly higher than that in group A (84.5 vs 77.4). The subgroup analysis showed that the benefit of cisplatin regimen chemotherapy was higher than that of carboplatin and AC regimen chemotherapy. But there was no significant difference in the control rate of acute nausea between the two groups (88.6 vs 85.40.41) Arepitan significantly increased CRR of delayed vomiting: Arebitam increased 7.8mb 62.9 vs 55.1R 1.39 P0.01M compared with 5-HT3RAC; compared with placebo, the CR increased by 1467.4 vs 53.4% P0.01; Arapitam combined with dexamethasone increased OR 1.85 P0.01; Arepitan versus placebo increased 1467.4 vs 53.4% P 0.01; Arepitan combined with dexamethasone increased 7.80.39 P0.01; Arepitan versus placebo increased 1467.4 vs 53.4% P 0.01; Arepitan combined with dexamethasone increased 7.82.9P 0.01; Dexamethasone CR increased 17.9% 73.2% vs 55.33.00% vs 2.22% P0.01k.3) Arepitan combined with dexamethasone increased the control rate of delayed nausea with dexamethasone 74.4 vs 65.1% OR1.55P0.01 .4) adverse reactions: the incidence of fatigue was higher in the Arepitan group than in the control group, while the incidence of constipation was higher than that in the control group. It was lower than control group (P < 0. 03), headache, There was no significant difference in the incidence of diarrhea and anorexia between the two groups. Conclusion: the clinical tolerance of aripitan is good, and the improvement of delayed vomiting, nausea and acute vomiting is obvious, especially in patients with cisplatin regimen chemotherapy. It is necessary to further observe the improvement of CINV induced by different chemotherapy regimens.
【作者单位】：北京中医药大学;中日医院中西医结合肿瘤科;
【分类号】：R969

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