title: Meta-analysis of the effects of oral and intravenous dexamethasone premedication in the prevention of paclitaxel-induced allergic reactions.
abstract: BACKGROUND
  Dexamethasone premedication is required to prevent paclitaxel-related hypersensitivity reactions (HSRs). Oral dexamethasone (PO-D) has been considered the standard premedication regimen. However, whether intravenous dexamethasone (IV-D) is feasible for preventing paclitaxel-related HSRs is still unclear. We conducted a meta-analysis to compare these two regimens.
  
  
  METHODS
  We performed a systematic search in the PubMed, China National Knowledge Infrastructure, and Web of Science databases for relevant articles published before June 2016. Outcomes included HSRs and severe HSRs. Statistical analyses were performed using RevMan 5.2 software.
  
  
  RESULTS
  Six studies comprising 1347 patients were included in the meta-analysis. The PO-D premedication regimen showed a significantly decreased incidence of severe HSRs compared with the IV-D regimen with an OR of 0.53 (95% CI 0.28-0.99, p = 0.05). However, there was no difference in the overall paclitaxel-related HSR rates between the two premedication regimens (OR 0.76, 95% CI 0.55-1.06, p = 0.11). Subgroup analyses according to study type and country of origin showed similar statistical results between the two premedication regimens.
  
  
  CONCLUSIONS
  Our meta-analysis showed that the PO-D premedication regimen is superior to the IV-D regimen in preventing paclitaxel-related HSRs. Additional randomized controlled trials are needed to confirm our findings.
authors.affiliation: Department of Pharmacy, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, 442008, P.R. China.
authors.forename: Fu-Chao
authors.initials: FC
authors.lastname: Chen
authors.affiliation: Department of Pharmacy, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, P.R. China.
authors.forename: Lin-Hai
authors.initials: LH
authors.lastname: Wang
authors.affiliation: International School of Software, Wuhan University, Wuhan, Hubei, 430079, P.R. China.
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Zheng
authors.affiliation: Department of Pharmacy, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, 442008, P.R. China.
authors.forename: Xiu-Min
authors.initials: XM
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, P.R. China.
authors.forename: Lin-Jun
authors.initials: LJ
authors.lastname: Li
mesh_terms: D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects; D002681:China; D003907:Dexamethasone / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007275:Injections, Intravenous; D009369:Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000009:adverse effects*; D011292:Premedication
chemical_list: D000893:Anti-Inflammatory Agents; D000972:Antineoplastic Agents, Phytogenic; D003907:Dexamethasone; D017239:Paclitaxel
keywords: allergic reaction; dexamethasone; meta-analysis; paclitaxel