Comparing Interventions for Management of Hot Flashes in Patients With Breast and Prostate Cancer: A Systematic Review With Meta-Analyses.
Brian Hutton, Mona Hersi, Wei Cheng and 12 others
PMID 32555553WHAT IT FOUND
For cancer survivors with hot flashes, venlafaxine had the best evidence for reducing frequency.
Other treatments showed uncertain or weak benefit, and no therapy had strong evidence for overall hot flash score.
Key findings
01Venlafaxine was the only intervention that reduced hot flash frequency versus placebo with moderate certainty.
02For hot flash composite score, no intervention had high or moderate certainty versus placebo, although paroxetine, clonidine, electro-acupuncture, and venlafaxine showed low-certainty reductions.
03Vitamin E was associated with a higher hot flash composite score than placebo, with very low certainty.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Many included trials had unclear or high risk of bias for randomization, allocation concealment, blinding, selective reporting, and intention-to-treat analysis. Important patient details were often missing, including cancer type, time since treatment, prior hot flash treatments, body mass index, smoking history, and socioeconomic status. Outcome reporting varied widely, and many treatment comparisons were disconnected, so physical and psychological therapies could not be compared in the main networks. The review excluded hormonal treatments for prostate cancer hot flashes, although progestational agents are commonly used in that population. Most studies were small and short. The median study size was 88 patients, and the median follow-up was 8 weeks. Quality of life, sleep, depression, and sexual function outcomes used many different scales, so only narrative summaries were possible.
Declared interests
The supplied text does not report an author conflict of interest statement. The publication types note research support from a non-U.S. government source.
The easy way to misread this
Do not read paroxetine as the best proven treatment. Its frequency benefit had low certainty, and venlafaxine was the only frequency result showing benefit with moderate certainty.