Smith, L.A., Azariah, F., Lavender, V.T., Stoner, N.S., & Bettiol, S. (2015). Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database of Systematic Reviews, 11, CD009464.
DOI Link
Purpose
STUDY PURPOSE: To evaluate the effectiveness and side effects of cannabinoids for chemotherapy-induced nausea and vomiting (CINV) in adults with cancer
Search Strategy
- DATABASES USED: MEDLINE, EMBASE, LILACS, PsycINFO, and Cochrane Collaboartion
- KEYWORDS: Search term details are provided .
- INCLUSION CRITERIA: Randomized controlled trails comparing cannabinoid with either placebo or an antiemetic medication.
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 23
Results
Nine trials compared cannabis with placebo. Two trials showed no difference between groups in complete absence of nausea, three trials showed likelihood of absence of vomiting with cannabinoids compared to placebo (RR = 5.7, 95% CI [2.6, 13]), and three trials showed more chance of complete absence of nausea and vomiting with cannabinoids (RR = 2.9, 95% CI [1.8, 4.7]). Patients tended prefer cannabis to placebo. Cannabinoids versus prochlorperazine: nine trials with 1,221 patients compared these two. No significant differences in risk of CINV were found. Patients preferred cannabis in seven trials. Few very small trials of other drug comparisons were reviewed. Overall analysis of comparison with other antiemetic drugs showed the effectiveness of cannabis; however, the quality of the evidence was low to moderate level.
Conclusions
Analysis showed that cannabinoids were more effective than placebo and were similar to a few antiemetics for the management of CINV.
Limitations
The study quality was low overall. Comparison antiemetics in included trials were not the most current and highly effective medications.
Nursing Implications
Cannabis-based medicines may be useful adjuncts for the management of CINV. More current research comparing cannabinoid efficacy alone or as adjunctive treatment with agents such as NK1 and 5HT3 would be useful. Some of the cannabis-related research has suggested effectiveness with nausea, which has not been managed as well as vomiting with current regimens.