Assessment of Antihistamines and Corticosteroids as Premedication in Rapid Drug Desensitization to Paclitaxel: Outcomes in 155 Procedures
| Autor: | Maria Pilar Berges-Gimeno, Emilio Alvarez-Cuesta, Lorena Bernal-Rubio, Ricardo Madrigal-Burgaleta, Laura Victoria Carpio-Escalona, Paula Lopez-Gonzalez, Eva Guerra |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Paclitaxel Premedication medicine.medical_treatment Provocation test Drug allergy Histamine Antagonists Cohort Studies Drug Hypersensitivity 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Adrenal Cortex Hormones medicine Humans Immunology and Allergy Prospective Studies Desensitization (medicine) Chemotherapy business.industry Middle Aged medicine.disease Antineoplastic Agents Phytogenic Injection Site Reaction Clinical trial Treatment Outcome 030104 developmental biology 030228 respiratory system chemistry Desensitization Immunologic Anesthesia Drug Therapy Combination Female Taxoids Antihistamine business |
| Zdroj: | The Journal of Allergy and Clinical Immunology: In Practice. 6:1356-1362 |
| ISSN: | 2213-2198 |
| DOI: | 10.1016/j.jaip.2017.11.013 |
| Popis: | Background In early clinical trials, infusion reactions during the administration of taxanes were managed using systematic premedication with antihistamines and corticosteroids before standard infusions. Consequently, these premedications are also administered before rapid drug desensitization (RDD) with taxanes. However, their role in RDD has not been studied. Objective To assess the need for premedication with antihistamines and corticosteroids to prevent hypersensitivity reactions in RDD to paclitaxel. Methods Over a 4-year period, we selected patients with confirmed hypersensitivity to paclitaxel (positive skin testing and/or drug provocation testing results) who had received paclitaxel through RDD. These patients were assigned to 2 prospective noninception cohorts: one cohort premedicated with antihistamine and corticosteroids and another cohort that was not. Results We assessed 66 paclitaxel-reactive patients, of whom 22 met the inclusion criteria. A total of 155 RDDs to paclitaxel were performed. There were no significant differences in tolerance to RDD between the cohorts. Conclusions Administering systematic premedication with corticosteroids and antihistamines had no significant effect on the effectiveness or safety of RDD in patients with confirmed hypersensitivity to paclitaxel in the study population. Moreover, these premedications can mask early signs of hypersensitivity and delay treatment. We believe that systematic premedication with these drugs for patients undergoing RDD should be carefully and individually assessed if their only purpose is to prevent breakthrough reactions during RDD. |
| Databáze: | OpenAIRE |
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