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Purpose <p>Infusion-related reaction (IRR) is a common adverse event induced by rituximab. Although first-generation histamine 1 receptor antagonists (H1RAs) are commonly used to prevent IRR, evidence on IRR suppression by the second-generation H1RA bepotastine is scarce. In this study, we assessed the inhibitory effects of bepotastine on rituximab-induced IRR and compared them with those of the first-generation H1RA diphenhydramine.</p> Methods <p>We retrospectively evaluated IRR incidence in patients with B-cell non-Hodgkin lymphoma who received their first dose of rituximab.</p> Results <p>The incidence of any grade IRR was 9.8% in the bepotastine group (<i>n</i> = 92), which was significantly lower than the 30.2% rate in the diphenhydramine group (<i>n</i> = 96; <i>p</i> &lt; 0.001). The incidence of grade 2 or higher IRR was similar between the two groups (6.5% vs. 12.5%; <i>p</i> = 0.16). Multivariable logistic regression analysis revealed that the risk of any grade IRR incidence was higher in patients with B symptoms and bulky disease. Premedication with bepotastine was an independent factor in reducing the risk of any grade IRR incidence (odds ratio = 0.19, 95% confidence interval: 0.08–0.47).</p> Conclusion <p>Bepotastine may be more effective than diphenhydramine in reducing the incidence of rituximab-induced IRR, particularly low-grade reactions.</p>

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Comparative inhibitory effects of bepotastine and diphenhydramine on rituximab-induced infusion reactions

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月29日

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  • Tomoki Hori,
  • Kazuhiro Yamamoto,
  • Tomoaki Nakagawa,
  • Rinako Nakagawa,
  • Masami Okayama,
  • Tamika Sudou,
  • Moe Hamasaki,
  • Mai Yasuda,
  • Shinya Kobayashi,
  • Fumihiko Nakamura,
  • Hideo Yagi,
  • Yumi Kitahiro,
  • Shigeki Ikushima,
  • Ikuko Yano

摘要

Purpose

Infusion-related reaction (IRR) is a common adverse event induced by rituximab. Although first-generation histamine 1 receptor antagonists (H1RAs) are commonly used to prevent IRR, evidence on IRR suppression by the second-generation H1RA bepotastine is scarce. In this study, we assessed the inhibitory effects of bepotastine on rituximab-induced IRR and compared them with those of the first-generation H1RA diphenhydramine.

Methods

We retrospectively evaluated IRR incidence in patients with B-cell non-Hodgkin lymphoma who received their first dose of rituximab.

Results

The incidence of any grade IRR was 9.8% in the bepotastine group (n = 92), which was significantly lower than the 30.2% rate in the diphenhydramine group (n = 96; p < 0.001). The incidence of grade 2 or higher IRR was similar between the two groups (6.5% vs. 12.5%; p = 0.16). Multivariable logistic regression analysis revealed that the risk of any grade IRR incidence was higher in patients with B symptoms and bulky disease. Premedication with bepotastine was an independent factor in reducing the risk of any grade IRR incidence (odds ratio = 0.19, 95% confidence interval: 0.08–0.47).

Conclusion

Bepotastine may be more effective than diphenhydramine in reducing the incidence of rituximab-induced IRR, particularly low-grade reactions.