Comparison Efficacy of Premedication Regimens Used to Prevent Paclitaxel Hypersensitivity

Abstract

Background: Paclitaxel is a widely used chemotherapy drug. Hypersensitivity reactions are among the most common adverse reactions to paclitaxel. During the years 2021-2023, the reported incidence of hypersensitivity was 4.75%, Which was the highest compared to the other chemotherapy drugs.

Objective: This study aimed to investigate the relationship between different premedication regimens and hypersensitivity, and to determine the factors associated with the occurrence of hypersensitivity in patients receiving Paclitaxel.

Materials and Methods: Data were collected from the hospital database of Maharaj Nakhon Si Thammarat Hospital. This study included cancer patients treated with Paclitaxel between October 1, 2022 and February 29, 2024.

Results: The results showed that a total of 217 patients had hypersensitivity 21 patients (9.67%) experienced hypersensitivity. The highest incidence of hypersensitivity occurred in patients who received premedication regimen A (Dexamethasone 20 mg IV, Chlorpheniramine 10 mg IV, Famotidine 20 mg oral), followed by regimen B (Dexamethasone 20 mg IV, Diphenhydramine 25 mg oral, Dexamethasone 4 mg oral 12,6 hr. before Paclitaxel) and C (Dexamethasone 20 mg IV, Diphenhydramine 25 mg oral, Famotidine 20 mg oral), respectively. Compared to patients who received premedication regimen C, Patients who received premedication regimens A and B had 1.1 times (95% CI; 0.301-4.153) and 0.8 times (95% CI; 0.253-3.076) the likelihood of developing hypersensitivity, respectively.

Conclusion: Although no statistically significant association was found, it was revealed that regimen C was observed to have the lowest incidence of hypersensitivity. The study's findings may provide a basis for consideration to select a premedication regimen to prevent hypersensitivity from Paclitaxel.