Good clinical and cost outcomes using dexrazoxane to treat accidental epirubicin extravasation

Arroyo, Patricia; Pérez, Ruth Ubago; Feijoo, M.A. Fernández; Hernández, Miguel Ángel Calleja

doi:10.4103/0973-1482.77081

Cited by 11 publications

(15 citation statements)

References 7 publications

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“…As previously mentioned by Arroyo et al [7], the usage of dexrazoxane yielded major cost savings; moreover, it has to be stated that if surgery is abandoned further costs can be avoided.…”

Section: Discussionmentioning

confidence: 92%

“…It is recommended to administer dexrazoxane within the first 6 h in the unaffected arm [2,4,5,8,9,10,11]. Several reports have described successful treatment with the use of dexrazoxane when administered within hours (ranging from 4 to 5 h) after the extravasation [2,3,5,7,11]. Recently, Muthuramalingam et al [8] summarized 12 cases of anthracycline extravasation that were treated with dexrazoxane in the UK.…”

Section: Discussionmentioning

confidence: 99%

“…The goal is to avoid early and extensive surgical intervention [1,11]. Furthermore, the pharmacological mechanisms of the bisdioxopiperazine dexrazoxane are not completely understood [7,11]. Several authors have suggested that due to the building of chelates as a metal ion chelator it may, firstly, prevent the formation of free radicals and, secondly, inhibit reversibly topomerase II, therefore working as a protective agent [1,3,7,8,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the pharmacological mechanisms of the bisdioxopiperazine dexrazoxane are not completely understood [7,11]. Several authors have suggested that due to the building of chelates as a metal ion chelator it may, firstly, prevent the formation of free radicals and, secondly, inhibit reversibly topomerase II, therefore working as a protective agent [1,3,7,8,10,11]. The recommended 3-day treatment schedule consists of a daily dose of 1,000 mg/m 2 on the 1st and 2nd days and 500 mg/m 2 on the 3rd day given once [1,2,4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Until recently, no effective conservative treatment had been described for the dreaded accidental anthracycline extravasation [4]. Nowadays, immediate treatment with dexrazoxane, the only proven antidote in the case of accidental anthracycline extravasation, has been implemented into daily clinical practice [1,4,5,7,8]. Despite topical DMSO, it is the recommended specific antidote to be used as soon as possible (ideally not after 6 h) after anthracycline extravasation, as mentioned in the ESMO-EONS guidelines [9].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Complete Recovery of a Wide Local Reaction by the Use of Dexrazoxane 72 Hours after Epirubicin Extravasation: Case Report and Review of the Literature

Aigner¹,

Bauernhofer²,

Petru

et al. 2014

Dermatology

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Background: Accidental extravasation of anthracyclines might result in devastating side effects and complications, including necrosis of tissue, with impairment of neighboring structures - most of them requiring surgery. Following recent approach guidelines, intravenous administration of dexrazoxane within 6 h after the event is recommended. Case Report: We report on a 63-year-old female patient with breast cancer treated with epirubicin combination therapy. She experienced extravasation on the distal right arm at the end of the very first cycle, being initially treated with dimethylsulfoxide 99% topically. Clinical symptoms became worse. Despite the interval between the event and referral, dexrazoxane was given once daily for 3 days. She recovered completely without any sequelae. Conclusion: To our knowledge, this is the first case report of a successful treatment and complete recovery by the use of dexrazoxane even 3 days after extensive epirubicin extravasation. Additionally, a review of the literature is given.

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“…As previously mentioned by Arroyo et al [7], the usage of dexrazoxane yielded major cost savings; moreover, it has to be stated that if surgery is abandoned further costs can be avoided.…”

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Complete Recovery of a Wide Local Reaction by the Use of Dexrazoxane 72 Hours after Epirubicin Extravasation: Case Report and Review of the Literature

Aigner¹,

Bauernhofer²,

Petru

et al. 2014

Dermatology

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Treatment of anthracycline extravasations using dexrazoxane

Conde-Estévez

Antonio

2013

Clin Transl Oncol

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Extravasation of cytotoxic agents is a true medical emergency. Dexrazoxane is the only licensed drug for the treatment of anthracycline extravasations. Dexrazoxane proved to be effective and moderately well tolerated. However, alternative approaches for the management of anthracycline extravasations are available such as topical DMSO and cooling. There appears to be general agreement about dexrazoxane usefulness when extravasations involve large volumes of anthracycline and/or central venous access device. Nevertheless, the non-invasive combination of DMSO and cooling is the most commonly described therapy, particularly in small anthracycline extravasations. Further research is still needed to establish unequivocal situations where dexrazoxane must be initiated.

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Profiles and Outcomes of Skin Injuries Caused by Injectable Drug Extravasation

Maezawa,

Inoue,

Satake

et al. 2023

Journal of Infusion Nursing

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Extravasation occurs when injectable drugs leak out of the blood vessels, damaging the surrounding tissues and causing a variety of skin injuries. This study aimed to comprehensively analyze extravasation risk, skin injury profiles, and outcomes for suspect drugs from the Japanese Adverse Drug Event Report (JADER) database. Adverse events were defined according to the Medical Dictionary for Regulatory Activities/Japanese version; the term extravasation (Standardized MedDRA Query Code: 20000136) was used in this analysis. The names of adverse events were entered as unified preferred terms and redefined to evaluate skin injury profiles. In addition, skin injury outcomes were divided into 2 broad categories: “improvement” and “no improvement.” Reporting odds ratios were used to detect signals for adverse events. A total of 656 cases of extravasation-related adverse events were reported between April 2004 and January 2022. Signals for extravasation-related adverse events were detected from 11 drugs. Then, their respective skin injury profiles and outcomes were determined. These results suggest a relationship between adverse events associated with extravasation and 11 drugs and identify the characteristics of each skin injury and their outcomes. These findings will contribute to improving the quality of infusion management in clinical practice.

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Good clinical and cost outcomes using dexrazoxane to treat accidental epirubicin extravasation

Cited by 11 publications

References 7 publications

Complete Recovery of a Wide Local Reaction by the Use of Dexrazoxane 72 Hours after Epirubicin Extravasation: Case Report and Review of the Literature

Complete Recovery of a Wide Local Reaction by the Use of Dexrazoxane 72 Hours after Epirubicin Extravasation: Case Report and Review of the Literature

Treatment of anthracycline extravasations using dexrazoxane

Profiles and Outcomes of Skin Injuries Caused by Injectable Drug Extravasation

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