Impact of institutional interventions on the rate of paclitaxel hypersensitivity reactions
Abstract Purpose Paclitaxel is associated with hypersensitivity reactions (HSRs). Intravenous premedication regimens have been devised to decrease the incidence and severity of HSRs. At our institution, intravenous dexamethasone, oral histamine 1 receptor antagonists (H1RA) and histamine 2 receptor antagonists (H2RA) were adopted as standard. Standardizations were implemented for consistent premedication use in all disease states. The purpose of this retrospective study was to compare the incidence and severity of HSRs before and after standardization.Methods Patients who received paclitaxel from April 20, 2018 to December 8, 2020 having a HSR were included in analysis. An infusion was flagged for review if a rescue medication was administered after the start of paclitaxel infusion. Incidence of all HSR prior to and post standardization were compared. A subgroup analysis of patients receiving paclitaxel for the first and second time was performed.Results There were 3581 infusions in the pre-standardization group and 1179 infusions in the post- standardization group. After review, 100 HSRs pre-standardization and 38 HSRs post-standardization were confirmed reactions. The rate of overall HSRs was 2.9% in the pre-standardization group and 3.3% in the post-standardization group (p=0.48). HSRs, during the first and second doses of paclitaxel, occurred in 10.2% of the pre-standardization and 8.5% in the post-standardization group (p=0.55). Conclusions This retrospective interventional study demonstrated that same-day intravenous dexamethasone, oral H1RA, and oral H2RA is a safe premedication regimen for paclitaxel. No change in severity of reactions was seen. Overall, better adherence to premedication administration was seen post standardization..
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Preprint| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
ResearchSquare.com - (2022) vom: 24. Nov. Zur Gesamtaufnahme - year:2022 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jao, Mark E [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-1732029/v1 |
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| PPN (Katalog-ID): |
XRA036361984 |
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| 520 | |a Abstract Purpose Paclitaxel is associated with hypersensitivity reactions (HSRs). Intravenous premedication regimens have been devised to decrease the incidence and severity of HSRs. At our institution, intravenous dexamethasone, oral histamine 1 receptor antagonists (H1RA) and histamine 2 receptor antagonists (H2RA) were adopted as standard. Standardizations were implemented for consistent premedication use in all disease states. The purpose of this retrospective study was to compare the incidence and severity of HSRs before and after standardization.Methods Patients who received paclitaxel from April 20, 2018 to December 8, 2020 having a HSR were included in analysis. An infusion was flagged for review if a rescue medication was administered after the start of paclitaxel infusion. Incidence of all HSR prior to and post standardization were compared. A subgroup analysis of patients receiving paclitaxel for the first and second time was performed.Results There were 3581 infusions in the pre-standardization group and 1179 infusions in the post- standardization group. After review, 100 HSRs pre-standardization and 38 HSRs post-standardization were confirmed reactions. The rate of overall HSRs was 2.9% in the pre-standardization group and 3.3% in the post-standardization group (p=0.48). HSRs, during the first and second doses of paclitaxel, occurred in 10.2% of the pre-standardization and 8.5% in the post-standardization group (p=0.55). Conclusions This retrospective interventional study demonstrated that same-day intravenous dexamethasone, oral H1RA, and oral H2RA is a safe premedication regimen for paclitaxel. No change in severity of reactions was seen. Overall, better adherence to premedication administration was seen post standardization. | ||
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| 700 | 1 | |a Segal, Eve M |e verfasserin |4 aut | |
| 700 | 1 | |a Miske, Abby F |e verfasserin |4 aut | |
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