Infusion reactions to infliximab in children and adolescents: frequency, outcome and a predictive model

Aliment Pharmacol Ther. 2003 Jan;17(1):75-84. doi: 10.1046/j.1365-2036.2003.01411.x.

Abstract

Background: Crohn's disease commonly affects children and adolescents, however the majority of research into the safety and efficacy of therapies for inflammatory bowel disease, including infliximab, has occurred only in adults.

Aim: To determine the rate of reactions in children following infliximab infusions, and to identify variables that might be predictive of those reactions.

Methods: We performed a retrospective review of all infliximab infusions performed at Columbus Children's Hospital from December 1998 through September 2001.

Results: Fifty-seven children received 361 infusions. Three hundred and fifty-five of the 361 infusions (98.3%) were completed. Fifty children had 304 repeat infusions. There were a total of 35 infusion related reactions. Female gender and the use of immunosuppressive medications for less than 4 months were risk factors for a reaction to infusion number 2. A reaction to infusion 2 and immunosuppressive use for less than 4 months were risk factors for infusion number 3.

Conclusions: The rate of infusion reactions in children receiving infliximab is similar to that in adults. Female gender, immunosuppressive use for less than 4 months and prior infusion reactions may be risk factors for subsequent infusion reactions in children.

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antirheumatic Agents / administration & dosage
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / drug therapy*
  • Child
  • Colitis, Ulcerative / drug therapy*
  • Crohn Disease / drug therapy*
  • Drug Interactions
  • Dyspnea / chemically induced
  • Female
  • Flushing / chemically induced
  • Gastrointestinal Agents / administration & dosage
  • Gastrointestinal Agents / adverse effects*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Infliximab
  • Infusions, Intravenous
  • Male
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Gastrointestinal Agents
  • Immunosuppressive Agents
  • Infliximab