Mandatory dexamethasone strictly monitored by pharmacists reduces the severity of pemetrexed-induced skin rash

Eur J Hosp Pharm. 2017 Sep;24(5):283-285. doi: 10.1136/ejhpharm-2016-000957. Epub 2016 Aug 3.

Abstract

Objective: The present study aimed to retrospectively examine the effectiveness of mandatory dexamethasone (m-DEX) strictly monitored by pharmacists collaborating with medical physicians and nurses for reducing pemetrexed (PEM)-induced skin rash in patients with non-squamous non-small-cell lung cancer (ns-NSCLC).

Methods: We compared the rash grades during the first cycle of PEM-containing regimens between patients who received m-DEX after February 2012 and those who received dexamethasone (DEX) at their physician's discretion (d-DEX) before January 2012.

Results: Of 163 patients with ns-NSCLC included in this study, 89 received d-DEX and 74 received m-DEX. The mean DEX doses the night before and the day after PEM administration were significantly higher in the m-DEX group than in the d-DEX group. The frequency of grade ≥2 skin rash was significantly lower in the m-DEX group than in the d-DEX group.

Conclusions: The use of m-DEX strictly monitored by pharmacists might significantly reduce the severity of PEM-induced skin rash.

Keywords: collaborative drug therapy management; dexamethasone; non-squamous non-small-cell lung cancer; pemetrexed; skin rash.