Infusion reactions to infliximab in children and adolescents: frequency, outcome and a predictive model
1Section of Pediatric Gastroenterology and Nutrition, Columbus Children's Hospital, 700 Children's Drive, Columbus, OH 43205-2696, USA. crandallw@pediatrics.ohio-state.edu
Insights
Infliximab infusion reactions in children with Crohn's disease are similar to adults. Female gender and short-term immunosuppressant use are risk factors for reactions during infliximab therapy.
Area of Science:
- Pediatric Gastroenterology
- Immunology
Background:
- Crohn's disease frequently impacts pediatric populations.
- Limited research exists on infliximab safety and efficacy in children, with most data from adult studies.
Purpose of the Study:
- To assess the incidence of infusion reactions in pediatric patients undergoing infliximab treatment.
- To identify potential predictors of these reactions in children.
Main Methods:
- A retrospective analysis of infliximab infusions administered at Columbus Children's Hospital between December 1998 and September 2001.
- Review of infusion records for 57 children receiving 361 infusions.
Main Results:
- A total of 35 infusion-related reactions occurred across 361 infusions (98.3% completion rate).
- Risk factors for a reaction to the second infusion included female gender and less than 4 months of immunosuppressive medication use.
- Risk factors for a reaction to the third infusion included a prior reaction to the second infusion and less than 4 months of immunosuppressive use.
Conclusions:
- The rate of infliximab infusion reactions in children is comparable to that observed in adults.
- Female gender, recent initiation of immunosuppressants (less than 4 months), and previous infusion reactions may predict future reactions in pediatric patients.
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.
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