Evaluation of Montelukast for the Prevention of Infusion-related Reactions With Daratumumab

Daratumumab monotherapy in relapsed and refractory multiple myeloma patients with severely compromised forced expiratory volume in one second

“…However, regarding the safety perspective, daratumumab monotherapy might be considered for RRMM patients with FEV1 <50%. Moreover, recent suggestions to introduce montelukast as pre-medication for daratumumab [ 14 , 15 ] could be a part of preventive measures on respiratory IRR for patients with low FEV1. This study’s case series and recent suggestion for preventive montelukast could contribute to establishing a better cohort study reflecting more reliable real-world outcomes of daratumumab monotherapy.…”

Toxicity management strategies for next-generation novel therapeutics in multiple myeloma

“…We recommend acetaminophen, diphenhydramine, dexamethasone, montelukast, and famotidine 15–60 min prior to drug administration ( Table 3 ). 31 – 33 After the initial cycle of either daratumumab formulation, famotidine and montelukast may be discontinued and a rapid taper of dexamethasone can be considered, especially in those patients that did not experience IRR, are steroid intolerant, or are receiving SC formulation. 24 , 34 , 35 In addition, we do not recommend > 20 mg weekly dexamethasone or equivalent at any time for patients > 75 years of age.…”

Roadmap for new practitioners to navigate the multiple myeloma landscape

“…The incidence may be reduced by giving the first dose over two days, as well as adding pre-medications prior to infusion such as acetaminophen, diphenhydramine, and corticosteroids. The addition of montelukast 10 mg tablet taken daily during cycle 1 has been shown to decrease the incidence of hypersensitivity reactions with IV formulation [ 33 ]. When assessing administration techniques, SQ daratumumab route was non-inferior to IV daratumumab in terms of efficacy, pharmacokinetics, and had an improved safety profile in patients with relapsed or refractory MM [ 34 ].…”

“…The addition of montelukast 10 mg tablet taken daily during cycle 1 has been shown to decrease the incidence of hypersensitivity reactions with IV J o u r n a l P r e -p r o o f formulation. 21 When assessing administration techniques, SQ daratumumab route was non-inferior to IV daratumumab in terms of efficacy, pharmacokinetics, and had an improved safety profile in patients with relapsed or refractory MM. 22 Regardless of the route of administration, a corticosteroid, acetaminophen, and antihistamine should be given prior to administration.…”