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- W4243014611 abstract "Infliximab is a chimeric human-murine immunoglobulin G1 kappa (IgG1 κ) monoclonal antibody that has a high affinity for human tumor necrosis factor α. It is now commonly used for the treatment of Crohn's disease (CD) and rheumatoid arthritis resistant to other therapies. Diamanti et al report an anaphylactic reaction to infliximab administration in two of their 7 patients receiving this therapy for CD, and they suggest that the prevalence of severe infusion reactions may be higher than reported in our study1Hyams JS Markowitz J Wyllie R. Use of infliximab in the treatment of Crohn's disease in children and adolescents.J Pediatr. 2000; 137: 192-196Abstract Full Text Full Text PDF PubMed Scopus (141) Google Scholar or in the literature. In our study, we observed infusion reactions in 3 of 19 patients, two of whom had subsequent infusions without difficulty. In an updated review of the combined experience of our three centers, we have now treated 160 patients with more than 1000 infliximab infusions and have observed an acute severe (anaphylactoid) reaction in <3% of our patients. Some of these patients have had the drug subsequently administered with pretreatment with corticosteroids and have done well. Others have refused repeat administration. One report has suggested a method for the use of infliximab in patients who have had severe infusion reactions.2Kugathasan S Welin SL Martinez A Rivera MT Heikenen JB Binion DG. Successful desensitization and therapeutic use of infliximab in adult and pediatric Crohn's disease patients with prior anaphylactic reaction.Inflamm Bowel Dis. 2001; 7: 34-37Crossref PubMed Google Scholar We have also observed a small number of other patients (<10%) who have experienced mild chest tightness or dyspnea that responded to slowing the infusion. There are no controlled data on the relationship of administering antihistamines, corticosteroids, or acetaminophen before infliximab infusion, although we are aware that this practice is common. The experience in adults who receive infliximab for CD is similar to ours. In the combined experience of two large centers (229 patients receiving 581 infusions),3Cohen RD Tasang JF Hanauer SB. Infliximab in Crohn's disease: first anniversary clinical experience.Am J Gastroenterol. 2000; 95: 3469-3477Crossref PubMed Google Scholar, 4Farrell RJ Shah SA Lodhavia PJ Alsahli M Falchuk KR Michetti P et al.Clinical experience with infliximab therapy in 100 patients with Crohn's disease.Am J Gastroenterol. 2000; 95: 3490-3497Crossref PubMed Google Scholar severe infusion reactions were seen in approximately 6% of patients. We believe the likelihood of a severe reaction to infliximab infusion is small and, like all therapies used in the treatment of a chronic disease, the risk-benefit ratio needs to be determined. Our observations as well as those of Diamanti et al demonstrate the importance of close monitoring during infliximab infusion with trained personnel readily available to deal with severe reactions." @default.
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- W4243014611 date "2002-05-01" @default.
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- W4243014611 doi "https://doi.org/10.1067/mpd.2002.123993" @default.
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