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

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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 databases 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
JournalNutrition and Dietetics
Volume75
Issue numberS1
DOIs
Publication statusPublished - 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{f1f4c1f0ca34430da5584801dff25aa3,
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 databases 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",
year = "2018",
doi = "10.1111/1747-0080.12426",
language = "English",
volume = "75",
pages = "42",
journal = "Nutrition and Dietetics",
issn = "1032-1322",
publisher = "Wiley-Academy",
number = "S1",

}

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

PY - 2018

Y1 - 2018

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 databases 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 databases 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 -