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The following is a summary of “Comparative inhibitory effects of bepotastine and diphenhydramine on rituximab-induced infusion reactions,” published in the April 2025 issue of International Journal of Hematology by Hori et al. 

Infusion-related reactions (IRRs) are frequent with rituximab. Data on bepotastine, a second-generation histamine 1 receptor antagonist (H1RA), for IRR prevention remains limited. 

Researchers conducted a retrospective study to assess the effects of bepotastine on rituximab-induced infusion reactions. Its efficacy was compared with that of the first-generation H1RA diphenhydramine. 

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

The results showed IRR incidence was 9.8% in the bepotastine group (n=92), significantly lower than 30.2% in the diphenhydramine group (n=96; P<0.001). Grade 2 or higher IRR incidence was similar between groups (6.5% vs. 12.5%; P=0.16). Multivariable logistic regression showed higher IRR risk in patients with B symptoms and bulky disease. Premedication with bepotastine was an independent factor in reducing IRR risk (odds ratio = 0.19, 95% CI: 0.08–0.47). 

Investigators found that bepotastine was more effective than diphenhydramine in reducing the incidence of rituximab-induced IRR, with a greater effect on low-grade reactions. 

Source: link.springer.com/article/10.1007/s12185-025-03990-6