评估用于抗癌剂快速脱敏的自动输液泵

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2024-10-25 DOI:10.1016/j.anai.2024.08.077

J. Lee , S. Ban , J. Han , S. Paik , J. Park , J. Jeong , Y. Kim , H. Kang

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引用次数: 0

摘要

导言：脱敏疗法是向出现过敏反应的患者重新提供必需药物的一种有前途的策略。然而，这一过程需要医务人员大量的人工干预，以调整每个步骤的剂量和速度。我们的目的是评估新型自动输液泵（AIP）的疗效，该泵旨在通过自动给药来简化这一过程。方法我们于 2022 年 11 月至 2024 年 2 月在首尔国立大学对 AIP 与手动输液进行了比较评估，以快速脱敏抗癌药物。结果对涉及 182 名患者的 754 个脱敏程序进行分析后发现，406 例（53.8%）患者使用了 AIP；卡铂（137 例，18.2%）、奥沙利铂（127 例，16.8%）和利妥昔单抗（66 例，8.8%）是最常用的药物。对于卡铂、奥沙利铂和顺铂等铂类药物（34.1% vs. 25%，p = 0.088）或紫杉醇和多西他赛等类固醇类药物（12.7% vs. 16.4%，p = 0.456），人工方法和 AIP 方法的突破性反应（BTR）发生率没有明显差异。不过，利妥昔单抗脱敏疗法的 BTR 率与人工输注（52.6%，p = 0.001）相比，AIP（14.3%）要低得多，而且加药步骤和输注持续时间相似。结论使用 AIP 进行脱敏是一种安全、省力的人工脱敏替代方法，与人工输注相比，利妥昔单抗脱敏的疗效尤其显著。

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EVALUATION OF AUTOMATED INFUSION PUMP FOR RAPID DESENSITIZATION TO ANTICANCER AGENTS

Introduction

Desensitization presents a promising strategy for reintroducing essential medications to patients experiencing hypersensitivity reactions. However, the process demands significant manual intervention from medical staff in order to adjust dosage and rate of each step. We aimed to assess the efficacy of a novel automated infusion pump (AIP) designed to streamline this process by automating drug administration.

Methods

We conducted a comparative evaluation of AIP versus manual infusion for rapid desensitization of anticancer agents at Seoul National University from November 2022 to February 2024. AIP is programmed to initiate and execute various specified protocols, progressing through predetermined steps automatically.

Results

Analysis of 754 desensitization procedures involving 182 patients revealed that 406 cases (53.8%) utilized the AIP; carboplatin (137 cases, 18.2%), oxaliplatin (127 cases, 16.8%), and rituximab (66 cases, 8.8%) were the most frequently administered medications. Breakthrough reaction (BTR) incidence did not significantly differ between manual and AIP methods for platinum-based agents such as carboplatin, oxaliplatin, and cisplatin (34.1% vs. 25%, p = 0.088) or taxanes such as paclitaxel and docetaxel (12.7% vs. 16.4%, p = 0.456). However, rituximab desensitization exhibited a significantly lower BTR rate with AIP (14.3%) compared to manual infusion (52.6%, p = 0.001), with similar up-dosing steps and infusion duration. Three instances of machine error necessitated a switch to manual infusion, but no adverse effects from infusion errors were reported.

Conclusions

The use of AIP for desensitization presents a safe and labor-saving alternative for manual desensitization, with particularly enhanced efficacy observed in rituximab desensitization compared to manual infusion.

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.