Antibodies to infliximab have been associated with a risk of infusion reactions in some studies of patients with inflammatory bowel disease.
However, many factors, such as immunomodulators and dosing schedule, may influence this association.
Dr O’Meara and colleagues provided a pooled estimate of the risk of infusion reactions according to patients’ antibodies to infliximab status and analyze the relationship of immunomodulators to this risk.
Public databases were searched for eligible studies.
Quality assessment was undertaken for all studies using Grading of Recommendations Assessment, Development and Evaluation criteria.
Raw data from studies meeting inclusion criteria were pooled for meta-analysis of effect estimates.
|7 of the 8 studies had a high risk of bias in at least 1 quality domain|
|Inflammatory Bowel Diseases|
Sensitivity analysis was performed for all outcomes. Funnel plot was performed to assess for publication bias.
The team identified 8 studies met the inclusion criteria, with a pooled total of 1351 subjects.
The researchers found 7 of the 8 studies had a high risk of bias in at least 1 quality domain.
The cumulative data indicated that there was a higher risk ratio (RR) of any acute infusion reaction, and severe infusion reactions in patients with antibodies to infliximab when compared with patients without antibodies to infliximab.
The team noted that RR of delayed hypersensitivity reactions was not significantly different between antibodies to infliximab positive and negative patients.
The researchers reported that patients prescribed immunomodulators during maintenance infliximab therapy had a reduction in their risk for antibodies to infliximab development, and infusion reactions.
Dr O’Meara's team concludes, "The presence of antibodies to infliximab is associated with a significantly higher risk of acute infusion reactions, but not delayed hypersensitivity reactions, in patients with inflammatory bowel disease."
"Concomitant immunomodulators reduce this risk."