Adjunct Histamine Blockers as Premedications to Prevent Carboplatin Hypersensitivity Reactions.
OBJECTIVE
The objective of this study was to evaluate the impact of premedications given as an adjunct to carboplatin on the incidence of hypersensitivity reactions in women with ovarian cancer. Medications of interest include a histamine1 (H1 ) and histamine2 (H2 ) blocker in addition to dexamethasone.


METHODS
This was a retrospective chart review evaluating the addition of an H1 and H2 blocker in addition to dexamethasone as standard premedications on the incidence of carboplatin hypersensitivity reactions (CHRs) in women with ovarian cancer.


MAIN RESULTS
The odds ratio for premedication use was 0.46 with a 95% confidence interval (0.17-1.27), suggesting that patients with premedication use had approximately half the risk of CHR compared with patients without premedication. The overall incidence of CHRs decreased from 7.9% at baseline to 3.2% after the addition of premedications. The incidence of CHRs was 5.2% in 58 patients with recurrent or progressive disease compared with 2.1% in 96 newly diagnosed patients. Lifetime dose greater than 3377 mg, number of cycles more than six, and progressive or recurrent disease were predictive factors of CHR in women with ovarian cancer.


PRINCIPAL CONCLUSIONS
Total lifetime exposure to carboplatin remains the greatest predictive factor of CHR in women with ovarian cancer. Although data analysis indicates the addition of premedications for all ovarian cancer patients receiving carboplatin did not result in a statistically significant reduction in CHRs, a patient benefit in CHR reduction was observed. A prospective study is needed to confirm these findings.
['Mach|Claire M|CM|', 'Lapp|Elisabeth A|EA|', 'Weddle|Kellie J|KJ|', 'Hunter|Rodney J|RJ|', 'Burns|Kimberly A|KA|', 'Parker|Crystal|C|', 'Brown|Jubilee|J|', 'Smith|Judith A|JA|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D016190:Carboplatin D003907:Dexamethasone D004342:Drug Hypersensitivity D004359:Drug Therapy, Combination D005260:Female D006634:Histamine H1 Antagonists D006635:Histamine H2 Antagonists D006801:Humans D015994:Incidence D008875:Middle Aged D010051:Ovarian Neoplasms D011292:Premedication D012189:Retrospective Studies D013781:Texas D055815:Young Adult
premedication carboplatin hypersensitivity ovarian cancer allergy