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Premedication with montelukast and rupatadine decreased rituximab infusion time, rate, severity of reactions and use of rescue medications.
Int J Cancer. 2020 Mar 18 [Online ahead of print]IJ

Abstract

Rituximab-associated infusion reactions (IRs) are significant burdens on oncology patients, caregivers and healthcare providers. We evaluated whether montelukast and rupatadine improve rituximab delivery, decrease frequency/severity of IRs and the number of medications used to control IRs. Using a nonrandomized clinical study design, we assessed adult rituximab naïve patients with B-cell lymphoid malignancies from January 2017 to July 2019. Prior to the first rituximab infusion patients received one of the premedication regimens: (i) standard premedications, diphenhydramine hydrochloride and acetaminophen ("SP" group); (ii) SP + montelukast ("M" group); (iii) SP + rupatadine ("R" group); (iv) SP + rupatadine + montelukast Schedule 1 ("M + R Schedule 1" group); (v) SP + rupatadine + montelukast Schedule 2 ("M + R Schedule 2" group). A total of 223 patients with a median age of 69 years were assessed. Demographics and treatment groups were comparable among all five groups. Mean rituximab infusion time was 290 min in the SP group versus 273, 261, 243 and 236 min in the M, R, M + R Schedule 1 and M + R Schedule 2 groups, respectively. The incidence of rituximab IRs was 75% in the SP group versus 44, 41, 22 and 22% in the M, R, M + R Schedule 1 and M + R Schedule 2 groups, respectively. The median reaction grade was 2 in the SP group and 0 in all other groups. The median number of rescue medications was 3 in the SP group and 0 in all other groups. In conclusion, montelukast and rupatadine significantly improved rituximab delivery, decreased the rate and severity of IRs and reduced the need for rescue medications.

Authors+Show Affiliations

Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada.Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada.Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada.Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada.Provincial Drug Reimbursement Programs, Cancer Care Ontario, Toronto, Ontario, Canada.Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32189328

Citation

Kotchetkov, Rouslan, et al. "Premedication With Montelukast and Rupatadine Decreased Rituximab Infusion Time, Rate, Severity of Reactions and Use of Rescue Medications." International Journal of Cancer, 2020.
Kotchetkov R, McLean J, Nay D, et al. Premedication with montelukast and rupatadine decreased rituximab infusion time, rate, severity of reactions and use of rescue medications. Int J Cancer. 2020.
Kotchetkov, R., McLean, J., Nay, D., Gerard, L., Hopkins, S., & Didiodato, G. (2020). Premedication with montelukast and rupatadine decreased rituximab infusion time, rate, severity of reactions and use of rescue medications. International Journal of Cancer. https://doi.org/10.1002/ijc.32985
Kotchetkov R, et al. Premedication With Montelukast and Rupatadine Decreased Rituximab Infusion Time, Rate, Severity of Reactions and Use of Rescue Medications. Int J Cancer. 2020 Mar 18; PubMed PMID: 32189328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Premedication with montelukast and rupatadine decreased rituximab infusion time, rate, severity of reactions and use of rescue medications. AU - Kotchetkov,Rouslan, AU - McLean,Jesse, AU - Nay,Derek, AU - Gerard,Lauren, AU - Hopkins,Sean, AU - Didiodato,Giulio, Y1 - 2020/03/18/ PY - 2020/01/14/received PY - 2020/02/28/revised PY - 2020/03/11/accepted PY - 2020/3/20/pubmed PY - 2020/3/20/medline PY - 2020/3/20/entrez KW - chemoimmunotherapy KW - infusion reaction KW - montelukast KW - rituximab KW - rupatadine JF - International journal of cancer JO - Int. J. Cancer N2 - Rituximab-associated infusion reactions (IRs) are significant burdens on oncology patients, caregivers and healthcare providers. We evaluated whether montelukast and rupatadine improve rituximab delivery, decrease frequency/severity of IRs and the number of medications used to control IRs. Using a nonrandomized clinical study design, we assessed adult rituximab naïve patients with B-cell lymphoid malignancies from January 2017 to July 2019. Prior to the first rituximab infusion patients received one of the premedication regimens: (i) standard premedications, diphenhydramine hydrochloride and acetaminophen ("SP" group); (ii) SP + montelukast ("M" group); (iii) SP + rupatadine ("R" group); (iv) SP + rupatadine + montelukast Schedule 1 ("M + R Schedule 1" group); (v) SP + rupatadine + montelukast Schedule 2 ("M + R Schedule 2" group). A total of 223 patients with a median age of 69 years were assessed. Demographics and treatment groups were comparable among all five groups. Mean rituximab infusion time was 290 min in the SP group versus 273, 261, 243 and 236 min in the M, R, M + R Schedule 1 and M + R Schedule 2 groups, respectively. The incidence of rituximab IRs was 75% in the SP group versus 44, 41, 22 and 22% in the M, R, M + R Schedule 1 and M + R Schedule 2 groups, respectively. The median reaction grade was 2 in the SP group and 0 in all other groups. The median number of rescue medications was 3 in the SP group and 0 in all other groups. In conclusion, montelukast and rupatadine significantly improved rituximab delivery, decreased the rate and severity of IRs and reduced the need for rescue medications. SN - 1097-0215 UR - https://www.unboundmedicine.com/medline/citation/32189328/Premedication_with_montelukast_and_rupatadine_decreased_rituximab_infusion_time,_rate,_severity_of_reactions_and_use_of_rescue_medications L2 - https://doi.org/10.1002/ijc.32985 DB - PRIME DP - Unbound Medicine ER -
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