title: Comparative effectiveness of ramosetron for preventing chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis.
abstract: OBJECTIVE
  This study aimed to evaluate the effectiveness and safety of ramosetron for chemotherapy-induced nausea and vomiting (CINV) through a systematic review of randomized controlled trials (RCTs).
  
  
  METHODS
  An electronic search of CENTRAL, Ovid MEDLINE, Ovid EMBASE, KoreaMed, KISS, KMbase, and DBpia was performed. Published RCTs comparing ramosetron treatment and other 5-HT3RAs to prevent CINV were included, and studies reporting at least one clinical outcome about efficacy were included. Assessment of risk of bias and data extraction of the included studies was conducted by two independent reviewers.
  
  
  RESULTS
  Sixteen RCTs were included, with nine studies reporting nausea and 13 reporting vomiting. In the acute phase, ramosetron significantly reduced nausea compared to other 5-HT3RAs (RR 1.11; 95 % CI 1.10 to 1.22, P = 0.03), as well as acute vomiting (RR 1.04, 95 % CI 1.01 to 1.08, P = 0.02). In the delayed phase, there was no difference in the complete response of nausea between ramosetron and other 5-HT3RAs, whereas ramosetron significantly decreased emesis compared to other 5-HT3RAs. Also, there were no significant differences between ramosetron versus other 5-HT3RAs for common adverse reactions such as headache, diarrhea, dizziness, and constipation.
  
  
  CONCLUSIONS
  This study's findings suggest that ramosetron for CINV is as effective and tolerable as other 5-HT3RAs, based on the currently available evidence from RCTs. However, owing to methodological flaws in the current RCTs, well-designed randomized controlled trials are needed to confirm the effect of ramosetron on acute or delayed CINV in cancer patients.
authors.affiliation: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Dague, South Korea.|College of Pharmacy, Kyungpook National Univesity, 80 Daehakro, Bukgu, Daegu, 41566, Republic of Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Song
authors.affiliation: Department of Nursing, College of Medicine, Chosun University, 309 Pilmum-daero, Dong-gu, Gwangju, 61452, Republic of Korea. shj5th@korea.ac.kr.
authors.forename: Hyun-Ju
authors.identifier: http://orcid.org/0000-0001-9019-1135
authors.initials: HJ
authors.lastname: Seo
authors.affiliation: Graduate School of Public Health, Seoul National University, Seoul, South Korea.|Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, Republic of Korea.
authors.forename: Heejeong
authors.initials: H
authors.lastname: Son
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001562:Benzimidazoles / Q000627:therapeutic use*; D006801:Humans; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D001562:Benzimidazoles; D012702:Serotonin Antagonists; C071315:ramosetron
keywords: Chemotherapy-induced nausea and vomiting; Meta-analysis; Ramosetron; Systematic review