Severe infusion reactions to infliximab: aetiology, immunogenicity and risk factors in patients with inflammatory bowel disease

• Published in: Alimentary pharmacology & therapeutics 2011-07, Vol.34 (1), p.51-58
• Main Authors: Steenholdt, C., Svenson, M., Bendtzen, K., Thomsen, O. Ø., Brynskov, J., Ainsworth, M. A.
• Format: Article
• Language: English
• Subjects: Adult; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - adverse effects; Anti-Inflammatory Agents - therapeutic use; Antibodies, Anti-Idiotypic - blood; Antibodies, Anti-Idiotypic - metabolism; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Biological and medical sciences; Digestive system; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunologic Factors - blood; Immunologic Factors - metabolism; Inflammatory Bowel Diseases - drug therapy; Infliximab; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pharmacology. Drug treatments; Risk Factors; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Young Adult
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2011.04682.x

Aliment Pharmacol Ther 2011; 34: 51–58 Summary Background  Infliximab (IFX) elicits acute severe infusion reactions in about 5% of patients with inflammatory bowel disease (IBD). Aim  To investigate the role of anti‐IFX antibodies (Ab) and other risk factors. Methods  The study included all IBD patients treated with IFX at a Danish university hospital until 2010 either continuously (IFX every 4–12 weeks) or episodically (reinitiation after >12 weeks). Anti‐IFX Ab were measured using radioimmunoassay. Results  Twenty‐five (8%) of 315 patients experienced acute severe infusion reactions. Univariate analysis showed that patients who reacted were younger at the time of diagnosis (19 vs. 26 years, P = 0.013) and at first IFX infusion (28 vs. 35 years, P = 0.012). Furthermore, they more often received episodic therapy (72% vs. 31%, P