title: Adjunct Histamine Blockers as Premedications to Prevent Carboplatin Hypersensitivity Reactions.
abstract: 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.
  
  
  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.
  
  
  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.
authors.affiliation: Department of Clinical Pharmacy and Administration, University of Houston, College of Pharmacy, Houston, Texas.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Mach
authors.affiliation: University of Incarnate Word, Feik School of Pharmacy, San Antonio, Texas.
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Lapp
authors.affiliation: Department of Pharmacy Practice, Purdue University, West Lafayette, Indiana.
authors.forename: Kellie J
authors.initials: KJ
authors.lastname: Weddle
authors.affiliation: Department of Pharmacy Practice, Texas Southern University, College of Pharmacy and Health Sciences, Houston, Texas.|Department of Pharmacy, Memorial Hermann Hospital-UTHealth Cancer Center-TMC, Houston, Texas.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Hunter
authors.affiliation: Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Burns
authors.affiliation: Department of Biostatistics and Applied Mathematics, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
authors.forename: Crystal
authors.initials: C
authors.lastname: Parker
authors.affiliation: Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
authors.forename: Jubilee
authors.initials: J
authors.lastname: Brown
authors.affiliation: Department of Clinical Pharmacy and Administration, University of Houston, College of Pharmacy, Houston, Texas.|Department of Pharmacy Practice, Texas Southern University, College of Pharmacy and Health Sciences, Houston, Texas.|Department of Pharmacy, Memorial Hermann Hospital-UTHealth Cancer Center-TMC, Houston, Texas.|Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center, Houston, Texas.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016190:Carboplatin / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000188:drug therapy* / Q000453:epidemiology*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy; D011292:Premedication; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D003907:Dexamethasone; D016190:Carboplatin
keywords: allergy; carboplatin; hypersensitivity; ovarian cancer; premedication