Crossover comparison of the antiemetic efficacy of nabilone and alizapride in patients with nonseminomatous testicular cancer receiving cisplatin therapy.

Niederle et al. ·Journal of Molecular Medicine

Klarer Nutzen GRADE Moderat 40 Zitate

Stichproben = 20 Pat.

KontrolleAlizaprid 3×150 mg/Tag oral

EndpunktEmesis-Episoden

Verblindungunklar

DesignRCT (Crossover)

Cannabinoidthc

Max. Dosis4.0 mg

Applikationoral

Kernaussage

Nabilone reduzierte Emesis-Episoden und Nausea-Dauer signifikant besser als Alizapride bei Cisplatin-Chemotherapie.

Zusammenfassung

n=20 Hodenkrebs-Patienten (Cisplatin, niedrigdosiert), Nabilone 2×2 mg/Tag vs. Alizaprid 3×150 mg/Tag, Crossover-RCT; Nabilone signifikant überlegen: Erbrechen-Median 1,1 vs. 2,9 Episoden (p<0,01), vollständige Nausea-Kontrolle 65% vs. 30% (p<0,01), Nausea-Dauer 1,3 h vs. 5,1 h (p<0,01). Mehr Nebenwirkungen unter Nabilone; Dosisreduktion empfohlen.

PopulationPatienten mit nicht-seminomatösem Hodenkarzinom ohne Vorbehandlung mit emetogener Chemotherapie, n=20

InterventionNabilone 2×2 mg/Tag oral

KontrolleAlizaprid 3×150 mg/Tag oral

OutcomeSignifikant weniger Emesis-Episoden unter Nabilone vs. Alizapride (Median 1,1 vs. 2,9; p<0,01); vollständige Nausea-Freiheit häufiger (65% vs. 30%; p<0,01); kürzere Nausea-Dauer (1,3 h vs. 5,1 h; p<0,01)

Vertrauen in die Evidenz

Moderat

Dritte von vier GRADE-Stufen, die Effektschätzung ist wahrscheinlich verlässlich.

Herabgestuft wegen

Ungenauigkeit

Qualitätsprofil

Größe ★★★★★

Verblindung —

Effektstärke Klarer Nutzen

Zitate / Jahr ★★★★★

Autoren

Niederle N, Schütte J, Schmidt CG.

DOI 10.1007/bf01728184↗

Design: RCT (Crossover)

Abstract

Twenty nonseminomatous testicular cancer patients not pretreated with emetogenic chemotherapy were included in a crossover study of antiemetic therapy. Patients were randomly assigned to receive either nabilone (2 X 2 mg/day) or alizapride (3 X 150 mg/day) prior to beginning low-dose cisplatin chemotherapy. Patients on nabilone had significantly fewer episodes of emesis than those on alizapride (medians, 1.1 vs 2.9; p less than 0.01). Nabilone was superior to alizapride in giving complete relief from nausea (medians, 65% vs 30%; p less than 0.01), and was more effective in shortening the duration of nausea (medians, 1.3 h vs 5.1 h; p less than 0.01); however, it caused more adverse effects. It is concluded that nabilone has greater antiemetic activity than alizapride in young patients receiving low-dose cisplatin chemotherapy. Nabilone dosage should be reduced to decrease the incidence and degree of adverse reactions while leaving the definite antiemetic activity unchanged.

„Was dem Handeln im Weg steht, wird zum Weg.“ — Marc Aurel