Title |
Comparative efficacy of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis
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Published in |
BMC Medicine, June 2015
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DOI | 10.1186/s12916-015-0371-y |
Pubmed ID | |
Authors |
Andrea C. Tricco, Charlene Soobiah, Erik Blondal, Areti A. Veroniki, Paul A. Khan, Afshin Vafaei, John Ivory, Lisa Strifler, Huda Ashoor, Heather MacDonald, Emily Reynen, Reid Robson, Joanne Ho, Carmen Ng, Jesmin Antony, Kelly Mrklas, Brian Hutton, Brenda R. Hemmelgarn, David Moher, Sharon E. Straus |
Abstract |
Serotonin (5-HT3) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients. We conducted a systematic review on the comparative efficacy of 5-HT3 receptor antagonists. Searches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT3 receptor antagonists with each other, placebo, and/or combined with other antiemetic agents for patients undergoing surgical procedures. Screening search results, data abstraction, and risk of bias assessment were conducted by two reviewers independently. Random-effects pairwise meta-analysis and network meta-analysis (NMA) were conducted. PROSPERO registry number: CRD42013003564. Overall, 450 studies and 80,410 patients were included after the screening of 7,608 citations and 1,014 full-text articles. Significantly fewer patients experienced nausea with any drug relative to placebo, except for ondansetron plus metoclopramide in a NMA including 195 RCTs and 24,230 patients. Significantly fewer patients experienced vomiting with any drug relative to placebo except for palonosetron plus dexamethasone in NMA including 238 RCTs and 12,781 patients. All agents resulted in significantly fewer patients with postoperative nausea and vomiting versus placebo in a NMA including 125 RCTs and 16,667 patients. Granisetron plus dexamethasone was often the most effective antiemetic, with the number needed to treat ranging from two to nine. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 2 | 40% |
Canada | 1 | 20% |
United Kingdom | 1 | 20% |
Unknown | 1 | 20% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 2 | 40% |
Members of the public | 2 | 40% |
Science communicators (journalists, bloggers, editors) | 1 | 20% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 2% |
Colombia | 1 | 2% |
Canada | 1 | 2% |
Unknown | 45 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 7 | 15% |
Researcher | 5 | 10% |
Other | 4 | 8% |
Student > Postgraduate | 4 | 8% |
Student > Bachelor | 3 | 6% |
Other | 9 | 19% |
Unknown | 16 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 24 | 50% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
Biochemistry, Genetics and Molecular Biology | 1 | 2% |
Agricultural and Biological Sciences | 1 | 2% |
Sports and Recreations | 1 | 2% |
Other | 3 | 6% |
Unknown | 16 | 33% |