Feasibility of a Clinical Trial Comparing the Use of Cetirizine to Replace Diphenhydramine in the Prevention of Reactions Related to Paclitaxel

NCT ID: NCT04237090

Last Updated: 2020-10-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-14

Study Completion Date

2020-09-04

Brief Summary

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Explore the randomized, controlled, double-blind design targeted for the final clinical trial to assess the acceptability of interventions and clinical outcome measures and to provide data making it possible to estimate the parameters necessary for the preparation, modification or even abandonment of the final study.

Detailed Description

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Paclitaxel is known to cause 30 to 40% of infusion-related reactions when no premedication is administered. It is agreed that all patients should receive premedication with dexamethasone, an H1 antagonist, such as diphenhydramine, and an H2 antagonist before the administration of paclitaxel. There are several cases where undesirable effects (eg. drowsiness, dry mouth, motor impatience) have been reported following the administration of this conventional premedication. Diphenhydramine is often accused because of its pharmacological properties.

A definitive, randomized, double-blind, non-inferiority study can assess whether cetirizine, a non-sedating H1 antagonist, can be used as an effective and safe alternative to diphenhydramine in the prevention of paclitaxel infusion-related reactions.

In the current proposed feasibility study, patients will be followed for the first two doses of paclitaxel. The goal is to explore the randomized, controlled, double-blind design targeted for the final clinical trial to assess the acceptability of interventions and clinical outcome measures and to provide data making it possible to estimate the parameters necessary for the preparation, modification or even abandonment of the final study.

Conditions

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Breast Cancer Lung Cancer Ovarian Cancer Oesophageal Cancer Head Cancer Neck Cervical Cancer Endometrial Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Diphenhydramine + placebo

Diphenhydramine 50 mg intravenous given in a 50 milliliters bag of sodium chloride 0.9 percent, with famotidine, 30 minutes before the paclitaxel infusion. 15 minutes infusion.

Lactose tablet 100 mg per os given 30 minutes before the paclitaxel infusion.with a 180 milliliters glass of water.

Group Type ACTIVE_COMPARATOR

Diphenhydramine

Intervention Type DRUG

Drug identification number : 02369567

Lactose pill

Intervention Type DRUG

Natural product number : 00501190

Cetirizine + placebo

Cetirizine tablet 10 mg per os given 30 minutes before the paclitaxel infusion.with a 180 milliliters glass of water.

1 milliliter of sodium chloride 0,9 percent intravenous given in a 50 milliliters bag of sodium chloride 0.9 percent, with famotidine, 30 minutes before the paclitaxel infusion. 15 minutes infusion.

Group Type EXPERIMENTAL

Cetirizine

Intervention Type DRUG

Drug identification number : 02231603

Sodium chloride 0.9%

Intervention Type DRUG

Drug identification number : 00037796

Interventions

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Diphenhydramine

Drug identification number : 02369567

Intervention Type DRUG

Cetirizine

Drug identification number : 02231603

Intervention Type DRUG

Lactose pill

Natural product number : 00501190

Intervention Type DRUG

Sodium chloride 0.9%

Drug identification number : 00037796

Intervention Type DRUG

Other Intervention Names

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Benadryl Reactine

Eligibility Criteria

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Inclusion Criteria

* Receiving intravenous chemotherapy treatments at the Maisonneuve-Rosemont hospital outpatient oncology clinic
* Starting their first lifetime treatment with paclitaxel (alone or in combination with other anticancer agents).
* Capable of giving free and informed consent and who agrees to participate by signing the consent form
* Aged 18 and over
* Able to complete questionnaires

Exclusion Criteria

* Does not understand French or English
* Taking chronic H1 antagonist orally
* Taking chronic systemic corticosteroids
* Contraindication or possible medical danger, such as a documented allergy or previous intolerance, related to the administration of cetirizine, diphenhydramine, placebo or any ingredient in their formulation
* Has received paclitaxel, docetaxel or paclitaxel nanoparticles linked to albumin in the past
* Receiving paclitaxel nanoparticles linked to albumin
* Severe renal impairment (Cockcroft-Gault \<10 milliliters/minute)
* Pregnant or breastfeeding women
* Receiving paclitaxel under desensitization protocol
* Documented or reported dysphagia or other pathophysiological condition preventing a tablet from being swallowed whole
* Interactions preventing the full dose of oral cetirizine from being absorbed
* Participating in another clinical trial simultaneously
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ciusss de L'Est de l'Île de Montréal

OTHER

Sponsor Role lead

Responsible Party

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Matthieu Picard

Assitant clinical professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Matthieu Picard, M.D.

Role: PRINCIPAL_INVESTIGATOR

Ciusss de L'Est de l'Île de Montréal

Locations

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CIUSSS de l'Est-de-l'île-de-Montréal

Montreal, Quebec, Canada

Site Status

Countries

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Canada

References

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Weiss RB, Donehower RC, Wiernik PH, Ohnuma T, Gralla RJ, Trump DL, Baker JR Jr, Van Echo DA, Von Hoff DD, Leyland-Jones B. Hypersensitivity reactions from taxol. J Clin Oncol. 1990 Jul;8(7):1263-8. doi: 10.1200/JCO.1990.8.7.1263.

Reference Type BACKGROUND
PMID: 1972736 (View on PubMed)

Picard M, Castells MC. Re-visiting Hypersensitivity Reactions to Taxanes: A Comprehensive Review. Clin Rev Allergy Immunol. 2015 Oct;49(2):177-91. doi: 10.1007/s12016-014-8416-0.

Reference Type BACKGROUND
PMID: 24740483 (View on PubMed)

Picard M. Management of Hypersensitivity Reactions to Taxanes. Immunol Allergy Clin North Am. 2017 Nov;37(4):679-693. doi: 10.1016/j.iac.2017.07.004. Epub 2017 Aug 18.

Reference Type BACKGROUND
PMID: 28965634 (View on PubMed)

Durham CG, Thotakura D, Sager L, Foster J, Herrington JD. Cetirizine versus diphenhydramine in the prevention of chemotherapy-related hypersensitivity reactions. J Oncol Pharm Pract. 2019 Sep;25(6):1396-1401. doi: 10.1177/1078155218811505. Epub 2018 Nov 12.

Reference Type BACKGROUND
PMID: 30419768 (View on PubMed)

Siderov J, Wendel N, Davis ID. Non-Sedating Antihistamines for Premedication in Ambulatory Oncology Patients. Journal of Pharmacy Practice and Research 2002; 32(2): 108-9.

Reference Type BACKGROUND

del Cuvillo A, Mullol J, Bartra J, Davila I, Jauregui I, Montoro J, Sastre J, Valero AL. Comparative pharmacology of the H1 antihistamines. J Investig Allergol Clin Immunol. 2006;16 Suppl 1:3-12. No abstract available.

Reference Type BACKGROUND
PMID: 17357372 (View on PubMed)

Banerji A, Long AA, Camargo CA Jr. Diphenhydramine versus nonsedating antihistamines for acute allergic reactions: a literature review. Allergy Asthma Proc. 2007 Jul-Aug;28(4):418-26. doi: 10.2500/aap.2007.28.3015.

Reference Type BACKGROUND
PMID: 17883909 (View on PubMed)

Berger MJ, Vargo C, Vincent M, Shaver K, Phillips G, Layman R, Macrae E, Mrozek E, Ramaswamy B, Wesolowski R, Shapiro CL, Lustberg MB. Stopping paclitaxel premedication after two doses in patients not experiencing a previous infusion hypersensitivity reaction. Support Care Cancer. 2015 Jul;23(7):2019-24. doi: 10.1007/s00520-014-2556-x. Epub 2014 Dec 18.

Reference Type BACKGROUND
PMID: 25519756 (View on PubMed)

Beaucage-Charron J, Gaudet L, Lamothe S, Pelletier C, Pepin AS, Roy V, Charpentier F, Lordkipanidze M, Projean D, Bouchard P, Picard M. A randomized double-blind feasibility study comparing cetirizine and diphenhydramine in the prevention of paclitaxel-associated infusion-related reactions: the PREMED-F1 study. Support Care Cancer. 2022 Apr;30(4):3389-3399. doi: 10.1007/s00520-021-06734-4. Epub 2022 Jan 8.

Reference Type DERIVED
PMID: 34997314 (View on PubMed)

Other Identifiers

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2020-2110

Identifier Type: -

Identifier Source: org_study_id

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