Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis
ObjectiveTo systematically evaluate the clinical efficacy and safety of fosaprepitant combined with 5-hydroxytryptamine 3 receptor antagonists (5-HT3RA) (with or without dexamethasone) on the chemotherapy-induced vomiting in pediatric cancer patients.MethodsPubMed, Embase, Cochrane Library, China Jo...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1509928/full |
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| author | Yanshuo Shi Yanshuo Shi Yuanyuan Yue Yuanyuan Yue Yue Zhang Guoxun Pang |
| author_facet | Yanshuo Shi Yanshuo Shi Yuanyuan Yue Yuanyuan Yue Yue Zhang Guoxun Pang |
| author_sort | Yanshuo Shi |
| collection | DOAJ |
| description | ObjectiveTo systematically evaluate the clinical efficacy and safety of fosaprepitant combined with 5-hydroxytryptamine 3 receptor antagonists (5-HT3RA) (with or without dexamethasone) on the chemotherapy-induced vomiting in pediatric cancer patients.MethodsPubMed, Embase, Cochrane Library, China Journal full-text database (CNKI), Wanfang data knowledge service platform (Wanfang) and VIP Chinese sci-tech Journal full-text database (VIP) were searched by computer (retrieval time from database establishment to Apr. 2024), randomized controlled trials (RCTs) and cohort studies about fosaprepitant and 5-HT3RA with or without dexamethasone (observation group) versus 5-HT3RA, with or without dexamethasone, as the control group for chemotherapy-induced vomiting were collected, after data extraction and quality evaluation, meta-analysis was carried out by Rev Man 5.3 software.ResultsA total of 731 patients were included in 7 trials. Meta-analysis results showed that the complete response (CCR, no vomiting/rescue medication) rates were higher in the observation group compared to that in the control group during the acute [the relative risk: RR = 1.64, 95% confidence interval: 95%CI = 1.35–1.99, P < 0.00001], delayed vomiting [RR = 2.05, 95%CI = 1.32–3.17, P = 0.001] and overall phases [RR = 2.08, 95%CI = 1.69–2.57, P < 0.00001], with statistical significance (P < 0.05). The subgroup analysis of salvage treatment proportion revealed that the need for rescue medication was higher for patients in the control than fosaprepitan regimens [RR = 0.20, 95%CI = 0.08–0.54, P = 0.001] There was no difference in the incidence of adverse drug reaction between two groups [RR = 0.95, 95%CI = 0.75–1.19, P = 0.66].ConclusionFosaprepitant in combination with 5-HT3RA (with or without dexamethasone) has the same safety and more effective in preventing chemotherapy-induced vomiting than 5-HT3RA with or without dexamethasone. |
| format | Article |
| id | doaj-art-555d0c12cfc043c98bf870d720b74a81 |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-555d0c12cfc043c98bf870d720b74a812025-01-23T06:56:15ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011610.3389/fphar.2025.15099281509928Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysisYanshuo Shi0Yanshuo Shi1Yuanyuan Yue2Yuanyuan Yue3Yue Zhang4Guoxun Pang5Department of Pharmacy, Hebei General Hospital, Shijiazhuang, ChinaHebei Key Laboratory of Clinical Pharmacy, Shijiazhuang, Hebei, ChinaDepartment of Pharmacy, Hebei General Hospital, Shijiazhuang, ChinaHebei Key Laboratory of Clinical Pharmacy, Shijiazhuang, Hebei, ChinaDepartment of Pharmacy, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Pharmacy, Hebei General Hospital, Shijiazhuang, ChinaObjectiveTo systematically evaluate the clinical efficacy and safety of fosaprepitant combined with 5-hydroxytryptamine 3 receptor antagonists (5-HT3RA) (with or without dexamethasone) on the chemotherapy-induced vomiting in pediatric cancer patients.MethodsPubMed, Embase, Cochrane Library, China Journal full-text database (CNKI), Wanfang data knowledge service platform (Wanfang) and VIP Chinese sci-tech Journal full-text database (VIP) were searched by computer (retrieval time from database establishment to Apr. 2024), randomized controlled trials (RCTs) and cohort studies about fosaprepitant and 5-HT3RA with or without dexamethasone (observation group) versus 5-HT3RA, with or without dexamethasone, as the control group for chemotherapy-induced vomiting were collected, after data extraction and quality evaluation, meta-analysis was carried out by Rev Man 5.3 software.ResultsA total of 731 patients were included in 7 trials. Meta-analysis results showed that the complete response (CCR, no vomiting/rescue medication) rates were higher in the observation group compared to that in the control group during the acute [the relative risk: RR = 1.64, 95% confidence interval: 95%CI = 1.35–1.99, P < 0.00001], delayed vomiting [RR = 2.05, 95%CI = 1.32–3.17, P = 0.001] and overall phases [RR = 2.08, 95%CI = 1.69–2.57, P < 0.00001], with statistical significance (P < 0.05). The subgroup analysis of salvage treatment proportion revealed that the need for rescue medication was higher for patients in the control than fosaprepitan regimens [RR = 0.20, 95%CI = 0.08–0.54, P = 0.001] There was no difference in the incidence of adverse drug reaction between two groups [RR = 0.95, 95%CI = 0.75–1.19, P = 0.66].ConclusionFosaprepitant in combination with 5-HT3RA (with or without dexamethasone) has the same safety and more effective in preventing chemotherapy-induced vomiting than 5-HT3RA with or without dexamethasone.https://www.frontiersin.org/articles/10.3389/fphar.2025.1509928/fullfosaprepitantchemotherapypediatric cancerantiemetic prophylaxismeta-analysis |
| spellingShingle | Yanshuo Shi Yanshuo Shi Yuanyuan Yue Yuanyuan Yue Yue Zhang Guoxun Pang Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis Frontiers in Pharmacology fosaprepitant chemotherapy pediatric cancer antiemetic prophylaxis meta-analysis |
| title | Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis |
| title_full | Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis |
| title_fullStr | Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis |
| title_full_unstemmed | Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis |
| title_short | Fosaprepitant as combination therapy to prevent chemotherapy-induced vomiting in children: a meta-analysis |
| title_sort | fosaprepitant as combination therapy to prevent chemotherapy induced vomiting in children a meta analysis |
| topic | fosaprepitant chemotherapy pediatric cancer antiemetic prophylaxis meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1509928/full |
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