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LETTER TO THE EDITOR

Treatment of Postoperative Nausea and Vomiting with Dolasetron Versus Ondansetron: Is There a Conflict of Interest?

Professor and Holder of the Margaret Milam McDermott Distinguished Chair in, Anesthesiology Department of Anesthesiology & Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, paul.white{at}utsouthwestern.edu

To the Editor:

In reading the article by Meyer et al. (1) suggesting that dolasetron (12.5 mg IV) "provided significantly greater efficacy for treatment of postoperative nausea and vomiting than ondansetron (4 mg IV) because of the need for less rescue therapy," I was surprised to note that Charles H. McLeskey, MD (the senior author) was a member of the Department of Pharmacy at the Texas A&M University System Health Science Center College of Medicine in Temple, Texas. For the past several years, Dr. McLeskey has worked in the medical department at Abbott Laboratories. As Abbott currently markets dolasetron (Anzamet®) for the treatment and prevention of postoperative nausea and vomiting, this would seem to suggest a potential conflict of interest. Curiously, Dr. McLeskey’s association with Abbott was not mentioned anywhere in the manuscript.

Another major concern regarding the authors’ conclusions relates to the fact that the study design was seriously flawed because the use of prophylactic antiemetics was not strictly controlled in either of the two treatment groups. Given the fact that all well-controlled, prospective comparative studies involving dolasetron and ondansetron have failed to find any differences between these two 5-HT₃ antagonists with respect to their antiemetic efficacy (2–4), the current findings are even more surprising. Hopefully, the results of this study will be confirmed by independent investigative groups without potential conflicts.

References

1. Meyer TA, Roberson CR, Rajab CR, et al. Dolasetron versus ondansetron for the treatment of postoperative nausea and vomiting. Anesth Analg 2005;100:373–7.[Abstract/Free Full Text]
2. Zarate E, Watcha MF, White PF, et al. A comparison of the costs and efficacy of ondansetron versus dolasetron for antiemetic prophylaxis. Anesth Analg 2000;90:1352–8.[Abstract/Free Full Text]
3. Sukhani R, Pappas AL, Luire J, et al. Ondansetron and dolasetron provide equivalent postoperative vomiting control after ambulatory tonsillectomy in dexamethasone-pretreated children. Anesth Analg 2002;95:1230–5.[Abstract/Free Full Text]
4. Olutoye O, Jantzen EC, Alexis R, et al. A comparison of the cost and efficacy of ondansetron and dolasetron in the prophylaxis of postoperative vomiting in pediatric patients undergoing ambulatory surgery. Anesth Analg 2003;97:390–6[Abstract/Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by White, P. F. Search for Related Content PubMed PubMed Citation Articles by White, P. F.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999