Infusion reactions 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 infusion reactions, but their efficacy is not known.
Dr Jacobstein and colleagues studied the proportion of pediatric patients receiving infliximab for IBD that developed infusion reactions and the potential effects of premedication on infusion reaction.
The researchers uniformly collected and retrospectively reviewed data from a cohort of pediatric patients with IBD enrolled between 2000 and 2003 at 6 pediatric centers.
|2 of 10 patients who began receiving premedication had a subsequent infusion reaction|
|Inflammatory Bowel Diseases|
The team analyzed a total of 1652 infusions given to 243 patients in 6 centers.
Overall, the research team recorded 60 infusion reactions in 40 patients.
33 of 243 patients in group 1 received premedication before the first infusion reaction.
The investigators reported that 210 patients in Group 2 did not receive premedication until the development of infusion reactions, if at all.
The investigative team noted that infusion reactions were more common among patients in group 1 than in group 2.
The researchers observed that of the 28 patients in group 2 with infusion reactions, 10 began receiving premedication with each subsequent infusion.
In addition, the team found that of the patients in group 2, 12 continued without premedications, and 6 had no further infusions recorded.
2 of 10 patients who began receiving premedication had a subsequent infusion reaction versus 6 of 12 who did not receive premedication.
Dr Jacobstein’s team concludes, “Infusion reactions occur in a small proportion of infusions among pediatric patients receiving infliximab for IBD."
"Premedication does not seem to prevent the development of infusion reactions.”
“However, once an infusion reaction has occurred, premedication may be indicated to prevent subsequent infusion reactions."