Histamine-2 (H 2 ) antagonists can be safely removed from standard paclitaxel premedication regimens.

Aims: The aim of this study is to investigate the rates of hypersensitivity reactions (HSRs) in patients receiving paclitaxel chemotherapy, with and without a histamine-2 (H ₂ ) antagonists.
Method: This prospective, multi-centre, cohort study compared patients receiving paclitaxel treated with premedication regimens containing chlorphenamine, dexamethasone and an H ₂ antagonist vs patients treated without an H ₂ antagonist. Rates of HSRs were described and logistic multivariable regression was used to investigate any associations with H ₂ antagonist treatment, adjusting for confounding variables.
Results: A total of 1043 individuals were included in the study; of these, 638 (61%) patients received an H ₂ antagonist and 405 (49%) were not given an H ₂ antagonist. Incidence of HSR in the cohort treated with H ₂ antagonists was 11.31% (n = 70) vs 9.86% (n = 41) in the cohort without. There was no statistically significant difference between the rates of HSR observed in those receiving and not receiving an H ₂ antagonist (odds ratio 1.04, 95% CI 0.65, 1.66, P = .9).
Conclusions: Results presented within the study are consistent with other recently published evidence to suggest that H ₂ antagonists do not confer any advantage as part of premedication regimens in reducing the incidence of HSR in patients treated with paclitaxel.
(© 2022 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)