{"title":"在治疗单克隆抗体相关输液反应引起的剧烈疼痛方面,美替利定与吗啡进行了比较。","authors":"Hanna Yakubi, Aaron Paul Steele, Megan Tsao","doi":"10.1177/10781552241259986","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Infusion reactions, characterized by symptoms such as rigors, fever, and hypotension, are common adverse events that occur during monoclonal antibody (MAB) therapy. The treatment of rigors often involves opioids, most commonly meperidine, despite limited evidence supporting use in the setting of MAB infusions. This study aims to compare the efficacy and safety of intravenous (IV) meperidine and morphine is treatment of MAB-related rigors, filling a significant gap in the literature.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study which reviewed patients either inpatient or within outpatient infusion centers from January 2015 to January 2024. Patients receiving IV 2 mg morphine or 25 mg meperidine for MAB-related rigors were included. The primary outcome was defined as the number of opioid doses required for rigors ablation. Secondary outcomes included rates of naloxone administration and documented sedation.</p><p><strong>Results: </strong>A total of 1251 administration events were screened, of which 127 and 26 rigor events were in the meperidine and morphine cohorts, respectively, were included. A majority of both cohorts required only one dose of either agent for rigors ablation with <20% of either cohort requiring 2 or more doses (p = 0.539). Low rates of sedation were observed in both groups.</p><p><strong>Conclusion: </strong>Both meperidine and morphine effectively manage MAB-related rigors within minimal safety concerns. These findings suggest that morphine is a suitable alternative to meperidine for this indication, which may influence future formulary decision, provide alternatives for drug shortage, and optimize supportive care for patients undergoing MAB therapy.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Meperidine compared to morphine for rigors associated with monoclonal antibody-related infusion reactions.\",\"authors\":\"Hanna Yakubi, Aaron Paul Steele, Megan Tsao\",\"doi\":\"10.1177/10781552241259986\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Infusion reactions, characterized by symptoms such as rigors, fever, and hypotension, are common adverse events that occur during monoclonal antibody (MAB) therapy. The treatment of rigors often involves opioids, most commonly meperidine, despite limited evidence supporting use in the setting of MAB infusions. This study aims to compare the efficacy and safety of intravenous (IV) meperidine and morphine is treatment of MAB-related rigors, filling a significant gap in the literature.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study which reviewed patients either inpatient or within outpatient infusion centers from January 2015 to January 2024. Patients receiving IV 2 mg morphine or 25 mg meperidine for MAB-related rigors were included. The primary outcome was defined as the number of opioid doses required for rigors ablation. Secondary outcomes included rates of naloxone administration and documented sedation.</p><p><strong>Results: </strong>A total of 1251 administration events were screened, of which 127 and 26 rigor events were in the meperidine and morphine cohorts, respectively, were included. A majority of both cohorts required only one dose of either agent for rigors ablation with <20% of either cohort requiring 2 or more doses (p = 0.539). Low rates of sedation were observed in both groups.</p><p><strong>Conclusion: </strong>Both meperidine and morphine effectively manage MAB-related rigors within minimal safety concerns. 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引用次数: 0
摘要
导言:以僵硬、发热和低血压等症状为特征的输液反应是单克隆抗体(MAB)治疗过程中常见的不良反应。尽管支持在 MAB 输注中使用阿片类药物的证据有限,但治疗僵硬的方法通常包括阿片类药物,最常见的是甲哌啶。本研究旨在比较静脉注射(IV)甲培利定和吗啡治疗 MAB 相关僵直的疗效和安全性,以填补文献中的重大空白:这是一项单中心、回顾性队列研究,回顾了2015年1月至2024年1月住院或门诊输液中心的患者。研究纳入了接受静脉注射 2 毫克吗啡或 25 毫克吗啡甲哌丁治疗人与生物免疫缺陷病毒相关僵硬症状的患者。主要结果定义为僵直消融所需的阿片类药物剂量。次要结果包括纳洛酮用药率和有记录的镇静率:结果:共筛查出 1251 例用药事件,其中甲哌啶和吗啡组分别有 127 例和 26 例抽搐事件。两个组群中的大多数人只需使用一次两种药物就能消除僵硬,结论如下:甲哌利定和吗啡都能有效消除僵硬:甲哌立定和吗啡都能有效控制与人与生物圈计划相关的僵直,且安全性极低。这些研究结果表明,在这一适应症中,吗啡是氯苯哌啶的合适替代品,这可能会影响未来的处方决定,为药物短缺提供替代品,并优化接受人与生物圈疗法的患者的支持性护理。
Meperidine compared to morphine for rigors associated with monoclonal antibody-related infusion reactions.
Introduction: Infusion reactions, characterized by symptoms such as rigors, fever, and hypotension, are common adverse events that occur during monoclonal antibody (MAB) therapy. The treatment of rigors often involves opioids, most commonly meperidine, despite limited evidence supporting use in the setting of MAB infusions. This study aims to compare the efficacy and safety of intravenous (IV) meperidine and morphine is treatment of MAB-related rigors, filling a significant gap in the literature.
Methods: This was a single-center, retrospective cohort study which reviewed patients either inpatient or within outpatient infusion centers from January 2015 to January 2024. Patients receiving IV 2 mg morphine or 25 mg meperidine for MAB-related rigors were included. The primary outcome was defined as the number of opioid doses required for rigors ablation. Secondary outcomes included rates of naloxone administration and documented sedation.
Results: A total of 1251 administration events were screened, of which 127 and 26 rigor events were in the meperidine and morphine cohorts, respectively, were included. A majority of both cohorts required only one dose of either agent for rigors ablation with <20% of either cohort requiring 2 or more doses (p = 0.539). Low rates of sedation were observed in both groups.
Conclusion: Both meperidine and morphine effectively manage MAB-related rigors within minimal safety concerns. These findings suggest that morphine is a suitable alternative to meperidine for this indication, which may influence future formulary decision, provide alternatives for drug shortage, and optimize supportive care for patients undergoing MAB therapy.
期刊介绍:
Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...