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Meta-analysis: rapid infliximab infusions are safe.
H C Neef1, M P Riebschleger, J Adler
1Division of Pediatric Gastroenterology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI 48109-5718, USA.
Alimentary Pharmacology & Therapeutics
|July 3, 2013
Summary
Rapid infliximab infusions (≤1-h) are safe and effective for patients with inflammatory bowel disease and other conditions. Shorter infusions reduce the risk of infusion reactions compared to standard 2- to 3-h infusions, conserving resources.
Area of Science:
- Pharmacology and Therapeutics
- Clinical Immunology
- Gastroenterology
Background:
- Infliximab infusions are typically long (2-3 hours), leading to significant time and cost burdens.
- Shorter infliximab infusion durations are used in some centers, but safety data are limited.
- Infusion reactions are a concern with biologic therapies like infliximab.
Purpose of the Study:
- To compare the risk of infusion reactions between standard (2-3 hour) and rapid (≤1 hour) infliximab infusions.
- To evaluate safety in patients with inflammatory bowel disease (IBD), rheumatoid arthritis, spondylarthropathy, and psoriatic disease.
Main Methods:
- A systematic literature search was conducted across MEDLINE, Embase, and Web of Science.
- Data from 10 studies involving 13,147 standard and 8,497 rapid infliximab infusions were analyzed.
- Relative risk (RR) of infusion reactions was pooled using random-effects models.
Main Results:
- Rapid (≤1-h) infliximab infusions showed a significantly decreased risk of infusion reactions compared to standard infusions (RR = 0.48, P = 0.009).
- This reduced risk was also observed in studies limited to IBD patients (RR = 0.49, P = 0.002).
- No significant differences in reaction risk were found with concomitant medication use or in high/medium quality studies.
Conclusions:
- Rapid infliximab infusions (≤1-h) are not associated with increased infusion reaction risk in selected patients who have tolerated previous standard infusions.
- One-hour infliximab infusions can conserve healthcare resources.
- Shorter infusions may improve patient adherence and quality of life.
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