{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:39:44Z","timestamp":1784990384781,"version":"3.55.0"},"reference-count":12,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Genentech Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Ocrelizumab is an effective medication for multiple sclerosis. However, infusion-related reactions (IRRs) are a concern for patients and may lead to discontinuation of ocrelizumab. To minimize IRRs, pre-medications are administered. However, from our experience, these medications, especially diphenhydramine, can cause marked drowsiness. The primary objective of this study was to evaluate whether cetirizine is non-inferior to diphenhydramine in limiting the proportion and severity of reactions from ocrelizumab infusions. Methods: Twenty participants were serially randomized in a 1:1 ratio to receive 10 mg of cetirizine or 25 mg of diphenhydramine orally prior to their first three ocrelizumab infusions. Results: The rate of IRRs in this study was similar across both treatment groups with no increase in the risk of severity, and no grade 3 IRRs. Further, patients receiving cetirizine experienced a reduction in fatigue. While there was not a significant difference in global satisfaction, this score increased over time in the cetirizine arm while it remained unchanged in the diphenhydramine arm. Conclusions: Overall, our results suggest that cetirizine does not increase the risk of infusion-related reactions compared to diphenhydramine.<\/jats:p>","DOI":"10.3390\/medicina60040659","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T06:28:09Z","timestamp":1713508089000},"page":"659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparing the Risk of Infusion-Related Reactions and Tolerability in Patients Given Cetirizine or Diphenhydramine Prior to Ocrelizumab Infusion (PRECEPT)"],"prefix":"10.3390","volume":"60","author":[{"given":"Kyle","family":"Smoot","sequence":"first","affiliation":[{"name":"Providence Brain and Spine Institute, Portland, OR 97225, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horia","family":"Marginean","sequence":"additional","affiliation":[{"name":"Providence Brain and Spine Institute, Portland, OR 97225, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Gervasi-Follmar","sequence":"additional","affiliation":[{"name":"Providence Brain and Spine Institute, Portland, OR 97225, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiayi","family":"Chen","sequence":"additional","affiliation":[{"name":"Providence Brain and Spine Institute, Portland, OR 97225, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1056\/NEJMoa1601277","article-title":"Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis","volume":"376","author":"Hauser","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1056\/NEJMoa1606468","article-title":"Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis","volume":"376","author":"Montalban","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s12325-021-01999-x","article-title":"The Role of Cetirizine in the Changing Landscape of IV Antihistamines: A Narrative Review","volume":"39","author":"Blaiss","year":"2022","journal-title":"Adv. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1007\/s12016-022-08932-2","article-title":"Premedication Protocols to Prevent Hypersensitivity Reactions to Chemotherapy: A Literature Review","volume":"62","author":"ALMuhizi","year":"2022","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1097\/NAN.0000000000000444","article-title":"Intravenous Cetirizine vs Intravenous Diphenhydramine for the Prevention of Hypersensitivity Infusion Reactions: Results of an Exploratory Phase 2 Study","volume":"44","author":"Holmes","year":"2021","journal-title":"J. Infus. Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.msard.2018.11.027","article-title":"Reduction in ocrelizumab-induced infusion reactions by a modified premedication protocol","volume":"27","author":"Conte","year":"2019","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_7","unstructured":"(2023, March 17). 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