Premedication and infusion reactions with infliximab: Results from a pediatric inflammatory bowel disease consortium
Article first published online: 14 DEC 2006
Copyright © 2005 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 11, Issue 5, pages 442–446, May 2005
How to Cite
Jacobstein, D. A., Markowitz, J. E., Kirschner, B. S., Ferry, G., Cohen, S. A., Gold, B. D., Winter, H. S., Heyman, M. B. and Baldassano, R. N. (2005), Premedication and infusion reactions with infliximab: Results from a pediatric inflammatory bowel disease consortium. Inflamm Bowel Dis, 11: 442–446. doi: 10.1097/01.MIB.0000158166.88238.ea
- Issue published online: 14 DEC 2006
- Article first published online: 14 DEC 2006
- Manuscript Accepted: 25 JAN 2005
- Manuscript Received: 20 JAN 2005
- NIH. Grant Number: DK060617
- M.B.H.. Grant Number: DK053708, and DK062149
- B.D.G., the VA HSR&D CDA Awardee. Grant Number: RCD00-013–2
- The Edmunds Family Fund
- Heineman Foundation (R.N.B.),
- The Wallace Family (H.S.W.)
- Patty and Charles Ribakoff II (H.S.W.)
- The National Philoptochos Children's Medical Fund (B.S.K.)
- The Nathan Cummings Foundation, Chicago, Illinois (B.S.K.)
- Crohn's and Colitis Foundation of America (CCFA)
- Crohn's disease;
- inflammatory bowel disease;
- infusion reactions
Background: Infusion reactions (IRs) are the most common adverse events associated with the use of infliximab for inflammatory bowel disease (IBD). Antipyretics, antihistamines, and corticosteroids have been used to prevent the development of IRs, but their efficacy is not known. We studied the proportion of pediatric patients receiving infliximab for IBD that developed IRs and the potential effects of premedication on IR.
Methods: Uniformly collected data from a cohort of pediatric patients with IBD enrolled between January 2000 and May 2003 at 6 pediatric centers were analyzed. Data were retrospectively reviewed and analyzed.
Results: A total of 1652 infusions given to 243 patients in 6 centers was analyzed. Overall, 60 IRs were recorded in 40 patients (3.6% of infusions, 16.5% of patients). Thirty-three of 243 patients received premedication before the first IR (group 1). Two hundred ten patients did not receive premedication until the development of IRs, if at all (group 2). IRs were more common among patients in group 1 than in group 2 (12/33 versus 28/210, P < 0.01). Of the 28 patients in group 2 with IRs, 10 began receiving premedication with each subsequent infusion, 12 continued without premedications, and 6 had no further infusions recorded. Two of 10 who began receiving premedication had a subsequent IR versus 6 of 12 who did not receive premedication (P = 0.15).
Conclusions: IRs occur in a small proportion of infusions among pediatric patients receiving infliximab for IBD. Premedication does not seem to prevent the development of IRs; however, once an IR has occurred, premedication may be indicated to prevent subsequent IRs.