Adjunct histamine blockers as premedications to prevent carboplatin hypersensitivity reactions

Abstract

OBJECTIVE:

The objective of this study is 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 (CHR) 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 one-half of the risk of CHR compared to patients without premedication. The overall incidence of CHR decreased from 7.9% at baseline to 3.2% after the addition of premedications. The incidence of CHR was 5.2% in patients with recurrent or progressive disease (N=58) compared to 2.1% in the newly diagnosed patients (N=96). Lifetime dose greater than 3377 milligrams, number of cycles greater 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. While data analysis indicates the addition of premedications for all ovarian cancer patients receiving carboplatin did not result in a statistically significant reduction in CHR, a patient benefit in CHR reduction was observed. A prospective study is needed to confirm these findings.