BACKGROUND: Episodic infliximab (IFX) treatment is associated with a higher risk for acute infusion reactions (AIR) and secondary loss of response (SLR), but this has not been evaluated in patients initially treated with an induction regimen with 3 IFX infusions. AIMS: To evaluate whether IFX reintroduction after > or = 4 months in patients treated with a 3-infusion induction regimen is associated with a higher incidence of AIR or SLR. METHODS: Incidence of immunogenic adverse effects was assessed in patients with inflammatory bowel disease who received > or = 4 consecutive IFX infusions (3 infusions at weeks 0, 2, and 6, plus > or = 1 maintenance infusion) (Continuous, n=47) and patients who were treated with a successful initial 3-infusion induction scheme and in whom IFX was then discontinued because of a complete response but reintroduced > or = 4 months later (Reintro, n=29). RESULTS: AIR rate was 17% in both groups, and SLR rate was 26% in the Continuous group and 15% in the Reintro group (not significant). The lack of concomitant immunomodulators and/or pretreatment with hydrocortisone were associated with AIR development (P=0.002). CONCLUSIONS: In patients who completed a 3-infusion induction regimen, IFX can be safely reintroduced even after a long time from discontinuation.
BACKGROUND:Episodic infliximab (IFX) treatment is associated with a higher risk for acute infusion reactions (AIR) and secondary loss of response (SLR), but this has not been evaluated in patients initially treated with an induction regimen with 3 IFX infusions. AIMS: To evaluate whether IFX reintroduction after > or = 4 months in patients treated with a 3-infusion induction regimen is associated with a higher incidence of AIR or SLR. METHODS: Incidence of immunogenic adverse effects was assessed in patients with inflammatory bowel disease who received > or = 4 consecutive IFX infusions (3 infusions at weeks 0, 2, and 6, plus > or = 1 maintenance infusion) (Continuous, n=47) and patients who were treated with a successful initial 3-infusion induction scheme and in whom IFX was then discontinued because of a complete response but reintroduced > or = 4 months later (Reintro, n=29). RESULTS: AIR rate was 17% in both groups, and SLR rate was 26% in the Continuous group and 15% in the Reintro group (not significant). The lack of concomitant immunomodulators and/or pretreatment with hydrocortisone were associated with AIR development (P=0.002). CONCLUSIONS: In patients who completed a 3-infusion induction regimen, IFX can be safely reintroduced even after a long time from discontinuation.
Authors: M J Casanova; M Chaparro; V García-Sánchez; O Nantes; E Leo; M Rojas-Feria; A Jauregui-Amezaga; S García-López; J M Huguet; F Arguelles-Arias; M Aicart; I Marín-Jiménez; M Gómez-García; F Muñoz; M Esteve; L Bujanda; X Cortés; J Tosca; J R Pineda; M Mañosa; J Llaó; J Guardiola; I Pérez-Martínez; C Muñoz; Y González-Lama; J Hinojosa; J M Vázquez; M P Martinez-Montiel; G E Rodríguez; R Pajares; M F García-Sepulcre; A Hernández-Martínez; J L Pérez-Calle; B Beltrán; D Busquets; L Ramos; F Bermejo; J Barrio; M Barreiro-de Acosta; O Roncedo; X Calvet; D Hervías; F Gomollón; M Domínguez-Antonaya; G Alcaín; B Sicilia; C Dueñas; A Gutiérrez; R Lorente-Poyatos; M Domínguez; S Khorrami; C Muñoz; C Taxonera; A Rodríguez-Pérez; A Ponferrada; M Van Domselaar; M L Arias-Rivera; O Merino; E Castro; J M Marrero; M Martín-Arranz; B Botella; L Fernández-Salazar; D Monfort; V Opio; A García-Herola; M Menacho; P Ramírez-de la Piscina; D Ceballos; P Almela; M Navarro-Llavat; V Robles-Alonso; A B Vega-López; I Moraleja; M T Novella; C Castaño-Milla; A Sánchez-Torres; J M Benítez; C Rodríguez; L Castro; E Garrido; E Domènech; E García-Planella; J P Gisbert Journal: Am J Gastroenterol Date: 2016-12-13 Impact factor: 10.864