紫杉醇存在输液相关反应（IRR）的风险，尽管没有前瞻性证据，但通常与预防性用药一起使用，包括皮质类固醇、H1受体拮抗剂和H2受体拮抗剂（H2RA）。供应中心的供应不足影响了静脉用H2RA的供应，因此它被从常规预防性用药中移除。作者比较了未使用H2RA预防性用药的患者与接受标准H2RA预防性用药的患者IRR的发生率。作者回顾了2019年12月至2021年10月期间在渥太华医院开始使用紫杉醇的门诊患者。共创建了两个队列：未使用H2RA预防性用药的患者（干预组）和接受标准H2RA预防性用药的患者（对照组）。回顾性收集了人口统计学、治疗和IRR信息。主要终点是在紫杉醇前两个剂量期间IRR≥2级的发生率。共有182名患者未使用H2RA预防性用药，相比之下，在非供应不足期间接受了184名对照患者的治疗。基线特征包括：中位年龄63岁，86%女性，原发肿瘤52%为乳腺/24%为妇科/10%为胃/食管/8%为肺/6%为其他。队列之间在基线特征上没有显著差异。在患者中IRR≥2级的发生率没有差异；在未使用H2RA的患者中，IRR≥2级占总数的12.1%（182例中的22例；95%置信区间【CI】为7.7%-17.7%），在对照患者中，IRR≥2级占总数的15.1%（185例中的28例；95%CI为10.3%-21.1%）。IRR≥3级的发生率也相似，在干预组中为4.4%，在对照组中为3.8%。从预防性用药中移除H2RA并没有增加IRR的发生率。需要重新评估使用H2RA预防性用药预防紫杉醇的IRR的效果。©2023美国癌症协会。

Paclitaxel has a risk of infusion-related reactions (IRRs) and despite no prospective evidence, is often given with premedication including a corticosteroid, H1 antagonist, and H2 antagonist (H2RA). Backorders impacted the supply of intravenous H2RAs at our center, and it was removed as routine premedication. The authors compared the incidence of IRR in patients treated without H2RA to patients receiving standard H2RA premedication.The authors reviewed outpatients starting paclitaxel at the Ottawa Hospital from December 2019 to October 2021. Two cohorts were created: patients treated without H2RA premedication (intervention), and those receiving standard H2RA (control). Demographics, treatment, and IRR information were collected retrospectively. Primary end point was rate of grade ≥2 IRRs during first two doses of paclitaxel.A total of 182 patients were treated without H2RA premedication, compared to 184 control patients treated during non-backorder periods. Baseline characteristics included: median age, 63 years; 86% female; and primary tumor 52% breast/24% gynecologic/10% gastric/esophageal/8% lung/6% other. There were no significant differences between cohorts in baseline characteristics. There was no difference in the rate of grade ≥2 IRR between cohorts; 12.1% (22 of 182; 95% confidence interval [CI], 7.7%-17.7%) for patients treated without H2RA, and 15.1% (28 of 185; 95% CI, 10.3%-21.1%) for control patients. The rate of grade ≥3 IRRs were also similar, 4.4% in intervention cohort versus 3.8% in control cohort.The removal of H2RAs from premedication for paclitaxel did not result in an increased incidence of IRRs. The use of H2RAs in preventing IRRs to paclitaxel should be re-evaluated.© 2023 American Cancer Society.