Tafelski, S., Häuser, W., & Schäfer, M. (2016). Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting—A systematic review of systematic reviews. Der Schmerz, 30, 14–24.
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Purpose
STUDY PURPOSE: To summarize systematic reviews that compared the efficacy, tolerability, and safety of cannabinoids with placebo or other antiemetics among patients of any age with any type of cancer
TYPE OF STUDY: Systematic review
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 6 systematic reviews
- TOTAL PATIENTS INCLUDED IN REVIEW = Not reported
- SAMPLE RANGE ACROSS STUDIES: Not reported
- KEY SAMPLE CHARACTERISTICS: All age groups were included (ages 3.5–82 years) with all types of cancers; cannabinoids included dronabinol (7.5–30 mg), levonantradol (1.5–3 mg), nabilone (1–7 mg), or whole plant extracts.
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Pediatrics, elder care, palliative care
Results
Moderate quality evidence exists that pharmaceutical cannabinoids are less tolerated and less safe than placebo or conventional antiemetics. Insufficient evidence exists to determine if cannabinoids are more efficient than newer antiemetics. The number needed to treat with cannabinoid compared to placebo or conventional antiemetics to achieve complete control of CINV is four patients. The number needed to harm with cannabinoid compared to placebo or conventional antiemetics is six patients.
Conclusions
A narrow range of patients achieve complete control of CINV with cannabinoid versus patients who experience harm with cannabinoids. Insufficient evidence exists regarding the efficiency of cannabinoids versus newer antiemetics.
Limitations
- Mostly low quality/high risk of bias studies
Nursing Implications
Cannabinoids should be considered for the treatment of uncontrolled or breakthough CINV but not as a first-line antiemetic for CINV.