Infliximab in inflammatory bowel disease. Is premedication necessary?
Infliximab en enfermedad inflamatoria intestinal. ¿Es necesario premedicar?
Adverse reactions
Colitis ulcerosa
Crohn's disease
Enfermedad de Crohn
Enfermedad inflamatoria intestinal
Inflammatory bowel disease
Infliximab
Reacciones adversas
Ulcerative colitis
Journal
Gastroenterologia y hepatologia
ISSN: 0210-5705
Titre abrégé: Gastroenterol Hepatol
Pays: Spain
ID NLM: 8406671
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
24
05
2020
revised:
08
07
2020
accepted:
13
07
2020
pubmed:
3
1
2021
medline:
3
11
2021
entrez:
2
1
2021
Statut:
ppublish
Résumé
The use of infliximab (IFX) in inflammatory bowel disease (IBD) has been associated with a 1-6% risk of infusion reactions. The usefulness of premedication with corticosteroids, paracetamol and /or antihistamines is controversial. The aim of this study is to assess, in IBD patients on IFX, whether there are differences in secondary reactions to the infusion between those who use premedication or not. A retrospective cohort study was performed identifying patients with a diagnosis of IBD who received IFX at our institution between January 2009 and July 2019. Acute reactions were defined as those that occurred in the first 24 hours postinfusion and late reactions for more than 24 hours. Infusion reactions were classified as mild, moderate and severe. Descriptive and association statistics were used (χ Sixty-four patients were included with 1,263 infusions in total, 52% men. Median infusions per patient was 22 (2-66). All induction infusions were administered with premedication, and in maintenance in 57% of them. Premedication was given with hydrocortisone, chlorphenamine and paracetamol. Most of reactions were acute, mild or moderate in severity and no patient needed to discontinue IFX. In the maintenance group, there were 9/718 (1.2%) infusion reactions with premedication and 4/358 (1.1%) without it (p = 0.606). In the induction group, there were 8/187 (4.3%) infusion reactions, significantly higher when compared with both maintenance groups. In this group, premedication use during maintenance was not effective at reducing the rate of infusion reactions. These results suggest that premedication would not be necessary.
Sections du résumé
BACKGROUND
BACKGROUND
The use of infliximab (IFX) in inflammatory bowel disease (IBD) has been associated with a 1-6% risk of infusion reactions. The usefulness of premedication with corticosteroids, paracetamol and /or antihistamines is controversial.
AIM
OBJECTIVE
The aim of this study is to assess, in IBD patients on IFX, whether there are differences in secondary reactions to the infusion between those who use premedication or not.
METHODS
METHODS
A retrospective cohort study was performed identifying patients with a diagnosis of IBD who received IFX at our institution between January 2009 and July 2019. Acute reactions were defined as those that occurred in the first 24 hours postinfusion and late reactions for more than 24 hours. Infusion reactions were classified as mild, moderate and severe. Descriptive and association statistics were used (χ
RESULTS
RESULTS
Sixty-four patients were included with 1,263 infusions in total, 52% men. Median infusions per patient was 22 (2-66). All induction infusions were administered with premedication, and in maintenance in 57% of them. Premedication was given with hydrocortisone, chlorphenamine and paracetamol. Most of reactions were acute, mild or moderate in severity and no patient needed to discontinue IFX. In the maintenance group, there were 9/718 (1.2%) infusion reactions with premedication and 4/358 (1.1%) without it (p = 0.606). In the induction group, there were 8/187 (4.3%) infusion reactions, significantly higher when compared with both maintenance groups.
CONCLUSIONS
CONCLUSIONS
In this group, premedication use during maintenance was not effective at reducing the rate of infusion reactions. These results suggest that premedication would not be necessary.
Identifiants
pubmed: 33386199
pii: S0210-5705(20)30362-9
doi: 10.1016/j.gastrohep.2020.07.018
pii:
doi:
Substances chimiques
Gastrointestinal Agents
0
Infliximab
B72HH48FLU
Types de publication
Journal Article
Observational Study
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
321-329Informations de copyright
Copyright © 2020 Elsevier España, S.L.U. All rights reserved.