Letter: rapid infliximab infusion is not always safe



Biological therapies with antitumour necrosis factor-α drugs, including infliximab, are now one of the popular therapies in the treatment of inflammatory bowel diseases and other diseases related to dysregulated immunity.[1, 2] Despite their effectiveness in control of exacerbations and maintaining remission of these diseases, this class of drugs may have serious side effects including death.[3-5] One of the major recommendations since introduction of infliximab, the first of these drugs to be commercially available, was slow infusion to avoid side effects. Neef et al. in their article have claimed that rapid infusion of infliximab is not associated with more side effects compared with standard infusion rate.[6]

As they have mentioned, this could not be generalised to every patient especially those who are naïve to this therapy. After several doses of infusion, patients usually develop antibodies to this chimeric protein. These antibodies could be neutralising or nonneutralising and accordingly could have different effects on occurrence of anaphylactic and other types of acute infusion reactions, as well as the efficacy of drug.[7-9]

I want to emphasise that the work of Neef et al. should not lead to a change in infusion rates for infliximab, especially in naïve patients.


Declaration of personal and funding interests: None.