Authors: Lee S Schwartzberg Edward J Stepanski Barry V Fortner Arthur C Houts
Publish Date: 2007/10/02
Volume: 16, Issue: 4, Pages: 393-398
Abstract
Monoclonal antibody MoAb treatments can result in severe infusion reactions Managing infusion reactions in the outpatient setting introduces clinical and resource challenges for patients and providers but there is little information regarding prevention management or outcomes of severe infusion reactions This study represents one of the first attempts to describe the clinical consequences of severe infusion reactions associated with MoAb treatmentClinic staff identified adults treated with rituximab cetuximab or bevacizumab who experienced a grade 3 or higher severe infusion reaction Chart reviews from 19 oncology practice sites across the USA captured patient demographics infusion reaction management procedures and clinical outcomesWith an average age of 62 years the sample comprised of 76 patients who experienced a severe infusion reaction while receiving rituximab n = 47 cetuximab n = 24 and bevacizumab n = 5 The most common pretreatment medications were acetaminophen and antihistamine in the rituximab group and corticosteroids 42 in the cetuximab group All cetuximab and the majority of rituximab severe infusion reactions occurred during the first cycle of therapy Postinfusion reaction management typically included corticosteroids oxygen and intravenous fluids Overall 22 were hospitalized for a mean of 4 days range = 20 to 60 days Permanent discontinuation of MoAb therapy occurred after the majority of cetuximab 79 to 100 related severe infusion reactionsFunding for this research was provided by a research grant from Amgen Thousand Oaks CA Amgen is the manufacturer of panitumumab a MoAb indicated for treatment of CRC LS conceived of the study and participated in the design and coordination of the study and interpreted the summary of data findings ES contributed to the design of the study supervised data collection and quality control procedures and supervised the summary of data findings BF contributed to the study design and coordination of the study AH supervised the summary of data findings and drafted the manuscript All authors read and approved the final manuscript
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