Systematic review | Outcome (comparison) | No. of RCTs (no. of participants) | Authors' meta-analysis result (95% CI), heterogeneity | Meta-analysis re-analyzed (95% CI), heterogeneity | Cannabinoid event rate, % | Control event rate, % | NNT |
Whiting et al, 2015[2] | Nausea and vomiting—complete response (versus placebo) | 3 (102) | OR = 3.82 (1.55 to 9.42), I[2] = 0% | RR = 2.43 (1.30 to 4.52), I[2] = 0% | 47 | 20 | 4 |
Smith et al, 2015[3] | Absence of nausea and vomiting (versus placebo) | 3 (288) | RR = 2.86 (1.76 to 4.65), I[2] = 0% | NA | 37 | 12 | 4 |
Patient preference (versus placebo) | 2 (256) | RR = 4.82 (1.74 to 13.36), I[2] = 69% | NA | 72 | 18 | 2 | |
Absence of nausea and vomiting (versus prochlorperazine) | 4 (414) | RR = 2.00 (0.74 to 5.38), I[2] = 60% | NA | 20 | 11 | NS | |
Patient preference (versus other drugs) | 9 (799) | RR = 2.76 (1.88 to 4.03), I[2] = 61% | NA | 63 | 19 | 3 | |
Mücke et al, 2016[1] | Improvement in nausea and vomiting symptoms (versus placebo)* | 2 (307) | SMD = 0.20 (–0.03 to 0.44), I[2] = 0% | NA | NA | NA | NA |
Machado Rocha et al, 2008[4] | Nausea and vomiting within 1 day of chemotherapy (dronabinol versus placebo) | 2 (185) | RR = 0.47 (0.19 to 1.16), I[2] = 91% | NA | 40 | 87 | NS |
Nausea and vomiting within 1 day of chemotherapy (dronabinol versus neuroleptics) | 5 (325) | RR = 0.67 (0.47 to 0.96), I[2] = 79% | NA | 52 | 80 | 4 | |
Nausea and vomiting within 1 day of chemotherapy (nabilone versus neuroleptics) | 6 (277) | RR = 0.88 (0.72 to 1.08), I[2] = 64% | NA | 75 | 85 | NS | |
Tramèr et al, 2001[5] | Control of nausea (versus placebo) | 4 (231) | RelR = 1.21 (1.03 to 1.42), I[2] = NR | NA | 70 | 57 | 8 |
Control of vomiting (versus placebo) | 4 (231) | RelR = 1.84 (1.42 to 2.38), I[2] = NR | NA | 66 | 36 | 4 | |
Control of nausea (versus antiemetic) | 7 (422) | RelR = 1.38 (1.18 to 1.62), I[2] = NR | NA | 59 | 43 | 7 | |
Control of vomiting (versus antiemetic) | 6 (395) | RelR = 1.28 (1.08 to 1.51), I[2] = NR | NA | 57 | 45 | 9 | |
Patient preference (versus placebo) | 4 (404) | RelR = 5.67 (3.95 to 8.15), I[2] = NR | NA | 76 | 13 | 2 | |
Patient preference (versus antiemetic) | 14 (1212) | RelR = 2.39 (2.05 to 2.78), I[2] = NR | NA | 61 | 26 | 3 | |
All studies | Control of nausea and vomiting (versus placebo) | 7 (500) | NA | RR = 3.60 (2.55 to 5.09), I[2] = 18% | 47 | 13 | 3 |
Control of nausea and vomiting (versus antiemetics) | 14 (1022) | NA | RR = 1.85 (1.18 to 2.91), I[2] = 60% | 31 | 16 | 7 |
NA: not applicable; NNT: number needed to treat; NR: not reported; NS: not significant; OR: odds ratio; RCT: randomized controlled trial; RelR: relative risk; RR: risk ratio; SMD: standardized mean difference.
* This was for palliative patients (1 HIV RCT and 1 refractory cancer pain RCT).Reproduced with permission from: Allan GM, Finley CR, Ton J, et al. Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms. Can Fam Physician 2018; 64:e78. Copyright © 2018 The College of Family Physicians of Canada.
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