Pharmacological prevention strategy for capecitabine‐induced hand‐foot syndrome: A network meta‐analysis of randomized control trials
Abstract
Capecitabine‐induced hand‐foot syndrome (HFS) is common in clinical practice. There are many regimens used to prevent HFS. However, the most effective preventive regimen has not yet been identified. Thus, we conducted a network meta‐analysis to investigate the best preventive regimen for HFS. The PRISMA‐NMA guidelines were used in this study. The PubMed, Cochrane, and Embase databases were searched. The main endpoint was set as HFS of National Cancer Institute grade 2 or more. We included only randomized control trials. The P‐score was used to rank the regimens. Among all the regimens, topical silymarin had the best preventive ability compared with the placebo (OR: 0.08; 95% CI: 0.01–0.71). The other identified effective regimen included pyridoxine (400 mg) and celecoxib; compared with the placebo, the odds ratio was 0.27 (95% CI: 0.08–0.91) and 0.41 (95% CI: 0.18–0.95), respectively. Topical silymarin is the most useful regimen for preventing capecitabine‐induced HFS.
How strong is the evidence?
Evidence Hub reads this as a randomized trial. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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