Efficacy of ginger (zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic literature review update and meta-analysis

Megan Crichton, Skye Marshall, Wolfgang Marx, Elisabeth Isenring

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Abstract

Nausea affects upwards of 60% of chemotherapy patients. Ginger has long been used in traditional medicine for alleviating nausea and vomiting; however, its use as an adjuvant therapy in patients undergoing chemotherapy is under-researched. Therefore, a systematic literature review and meta-analysis was undertaken to evaluate the efficacy of ginger supplementation in the prevention and management of chemotherapy-induced nausea and vomiting. Five electronic data bases were searched from database inception to October 2017. Intervention studies which administered ginger supplementation and a control (placebo or anti-emetic) to adults receiving chemotherapy were included,critically appraised using the Cochrane Risk of Bias tool, and pooled using meta-analysis. Seventeen papers were included. Ginger supplementation of any dose or duration had no effect on overall nausea incidence (OR: 0.80 [95% CI: 0.50–1.30] P = 0.37). There were trends towards improved nausea incidence for ginger supplementation of > 3-days (OR: 0.54 [95% CI: 0.23–1.23] P = 0.14; n = 5 studies; I2= 67%)and of doses > 1 g/day (OR: 0.56 [95% CI: 0.21–1.51] P = 0.25; n =4 studies; I2=67%). Ginger supplementation appeared to be more effective for acute nausea (OR:0.73 [95% CI: 0.50–1.06] P = 0.10; n =4 studies; I2= 57%) than delayed nausea (OR:1.03 [95% I:0.76–1.39]P = 0.87; I2= 20%). Ginger administration for > 3-days significantly reduced overall vomiting incidence (OR: 0.58 [95% CI: 0.38–0.90] P =0.01; n = 5 studies; I2= 74%) and delayed vomiting incidence (OR:0.44 [95% CI: 0.25–0.78] P = 0.005; n = 3 studies; n = 239 participants; I2= 83%). Sensitivity analysis did not explain the substantial heterogeneity in the pooled outcomes. Ginger supplementation of >1 g/day for > 3-days may improve chemotherapy-induced nausea and vomiting incidence; however, existing research remains inconsistent.Further research using strong designs, adequate sample sizes and standardized ginger products is warranted prior to routine clinical prescription.
Original languageEnglish
Pages (from-to)42
Number of pages1
JournalNutrition and Dietetics
Volume75
Issue numberS1
DOIs
Publication statusPublished - 15 May 2018
EventDietitians Association of Australia 35th National Conference: Think Big - ICC , Sydney, Australia
Duration: 17 May 201819 May 2018
Conference number: 35
http://daa2018.com.au/

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Ginger
Nausea
Vomiting
Meta-Analysis
Drug Therapy
Incidence
Databases
Antiemetics
Traditional Medicine
Research
Sample Size
Prescriptions
Placebos

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@article{7559cecc66fb479482f9585e4e5e3e5d,
title = "Efficacy of ginger (zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic literature review update and meta-analysis",
abstract = "Nausea affects upwards of 60{\%} of chemotherapy patients. Ginger has long been used in traditional medicine for alleviating nausea and vomiting; however, its use as an adjuvant therapy in patients undergoing chemotherapy is under-researched. Therefore, a systematic literature review and meta-analysis was undertaken to evaluate the efficacy of ginger supplementation in the prevention and management of chemotherapy-induced nausea and vomiting. Five electronic data bases were searched from database inception to October 2017. Intervention studies which administered ginger supplementation and a control (placebo or anti-emetic) to adults receiving chemotherapy were included,critically appraised using the Cochrane Risk of Bias tool, and pooled using meta-analysis. Seventeen papers were included. Ginger supplementation of any dose or duration had no effect on overall nausea incidence (OR: 0.80 [95{\%} CI: 0.50–1.30] P = 0.37). There were trends towards improved nausea incidence for ginger supplementation of > 3-days (OR: 0.54 [95{\%} CI: 0.23–1.23] P = 0.14; n = 5 studies; I2= 67{\%})and of doses > 1 g/day (OR: 0.56 [95{\%} CI: 0.21–1.51] P = 0.25; n =4 studies; I2=67{\%}). Ginger supplementation appeared to be more effective for acute nausea (OR:0.73 [95{\%} CI: 0.50–1.06] P = 0.10; n =4 studies; I2= 57{\%}) than delayed nausea (OR:1.03 [95{\%} I:0.76–1.39]P = 0.87; I2= 20{\%}). Ginger administration for > 3-days significantly reduced overall vomiting incidence (OR: 0.58 [95{\%} CI: 0.38–0.90] P =0.01; n = 5 studies; I2= 74{\%}) and delayed vomiting incidence (OR:0.44 [95{\%} CI: 0.25–0.78] P = 0.005; n = 3 studies; n = 239 participants; I2= 83{\%}). Sensitivity analysis did not explain the substantial heterogeneity in the pooled outcomes. Ginger supplementation of >1 g/day for > 3-days may improve chemotherapy-induced nausea and vomiting incidence; however, existing research remains inconsistent.Further research using strong designs, adequate sample sizes and standardized ginger products is warranted prior to routine clinical prescription.",
author = "Megan Crichton and Skye Marshall and Wolfgang Marx and Elisabeth Isenring",
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Efficacy of ginger (zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic literature review update and meta-analysis. / Crichton, Megan; Marshall, Skye; Marx, Wolfgang; Isenring, Elisabeth.

In: Nutrition and Dietetics, Vol. 75, No. S1, 15.05.2018, p. 42.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

T1 - Efficacy of ginger (zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic literature review update and meta-analysis

AU - Crichton, Megan

AU - Marshall, Skye

AU - Marx, Wolfgang

AU - Isenring, Elisabeth

N1 - Presenter: Megan Crichton

PY - 2018/5/15

Y1 - 2018/5/15

N2 - Nausea affects upwards of 60% of chemotherapy patients. Ginger has long been used in traditional medicine for alleviating nausea and vomiting; however, its use as an adjuvant therapy in patients undergoing chemotherapy is under-researched. Therefore, a systematic literature review and meta-analysis was undertaken to evaluate the efficacy of ginger supplementation in the prevention and management of chemotherapy-induced nausea and vomiting. Five electronic data bases were searched from database inception to October 2017. Intervention studies which administered ginger supplementation and a control (placebo or anti-emetic) to adults receiving chemotherapy were included,critically appraised using the Cochrane Risk of Bias tool, and pooled using meta-analysis. Seventeen papers were included. Ginger supplementation of any dose or duration had no effect on overall nausea incidence (OR: 0.80 [95% CI: 0.50–1.30] P = 0.37). There were trends towards improved nausea incidence for ginger supplementation of > 3-days (OR: 0.54 [95% CI: 0.23–1.23] P = 0.14; n = 5 studies; I2= 67%)and of doses > 1 g/day (OR: 0.56 [95% CI: 0.21–1.51] P = 0.25; n =4 studies; I2=67%). Ginger supplementation appeared to be more effective for acute nausea (OR:0.73 [95% CI: 0.50–1.06] P = 0.10; n =4 studies; I2= 57%) than delayed nausea (OR:1.03 [95% I:0.76–1.39]P = 0.87; I2= 20%). Ginger administration for > 3-days significantly reduced overall vomiting incidence (OR: 0.58 [95% CI: 0.38–0.90] P =0.01; n = 5 studies; I2= 74%) and delayed vomiting incidence (OR:0.44 [95% CI: 0.25–0.78] P = 0.005; n = 3 studies; n = 239 participants; I2= 83%). Sensitivity analysis did not explain the substantial heterogeneity in the pooled outcomes. Ginger supplementation of >1 g/day for > 3-days may improve chemotherapy-induced nausea and vomiting incidence; however, existing research remains inconsistent.Further research using strong designs, adequate sample sizes and standardized ginger products is warranted prior to routine clinical prescription.

AB - Nausea affects upwards of 60% of chemotherapy patients. Ginger has long been used in traditional medicine for alleviating nausea and vomiting; however, its use as an adjuvant therapy in patients undergoing chemotherapy is under-researched. Therefore, a systematic literature review and meta-analysis was undertaken to evaluate the efficacy of ginger supplementation in the prevention and management of chemotherapy-induced nausea and vomiting. Five electronic data bases were searched from database inception to October 2017. Intervention studies which administered ginger supplementation and a control (placebo or anti-emetic) to adults receiving chemotherapy were included,critically appraised using the Cochrane Risk of Bias tool, and pooled using meta-analysis. Seventeen papers were included. Ginger supplementation of any dose or duration had no effect on overall nausea incidence (OR: 0.80 [95% CI: 0.50–1.30] P = 0.37). There were trends towards improved nausea incidence for ginger supplementation of > 3-days (OR: 0.54 [95% CI: 0.23–1.23] P = 0.14; n = 5 studies; I2= 67%)and of doses > 1 g/day (OR: 0.56 [95% CI: 0.21–1.51] P = 0.25; n =4 studies; I2=67%). Ginger supplementation appeared to be more effective for acute nausea (OR:0.73 [95% CI: 0.50–1.06] P = 0.10; n =4 studies; I2= 57%) than delayed nausea (OR:1.03 [95% I:0.76–1.39]P = 0.87; I2= 20%). Ginger administration for > 3-days significantly reduced overall vomiting incidence (OR: 0.58 [95% CI: 0.38–0.90] P =0.01; n = 5 studies; I2= 74%) and delayed vomiting incidence (OR:0.44 [95% CI: 0.25–0.78] P = 0.005; n = 3 studies; n = 239 participants; I2= 83%). Sensitivity analysis did not explain the substantial heterogeneity in the pooled outcomes. Ginger supplementation of >1 g/day for > 3-days may improve chemotherapy-induced nausea and vomiting incidence; however, existing research remains inconsistent.Further research using strong designs, adequate sample sizes and standardized ginger products is warranted prior to routine clinical prescription.

U2 - 10.1111/1747-0080.12426

DO - 10.1111/1747-0080.12426

M3 - Meeting Abstract

VL - 75

SP - 42

JO - Nutrition and Dietetics

JF - Nutrition and Dietetics

SN - 1032-1322

IS - S1

ER -