Rapid Infliximab Infusion in Children: A Multicenter Retrospective Cohort Study
Raffi Lev-Tzion1, Amit Assa, Baruch Yerushalmi
1*Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, Jerusalem†Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv‡Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva§Pediatric Gastroenterology, Hepatology and Nutrition Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer||The Hebrew University of Jerusalem, Jerusalem, Israel.
Insights
Rapid infliximab infusions in pediatric inflammatory bowel disease (IBD) are safe. A 1-hour infusion protocol for pediatric IBD patients showed similar infusion reaction rates to standard 2- to 3-hour infusions.
Area of Science:
- Pediatric Gastroenterology
- Immunopharmacology
Background:
- Limited data exists on rapid infliximab infusions in pediatric patients.
- Infliximab is a crucial biologic therapy for pediatric inflammatory bowel disease (IBD).
Purpose of the Study:
- To evaluate the safety and efficacy of a 1-hour rapid infusion protocol for infliximab in pediatric IBD patients.
- To compare infusion reaction rates between rapid (1-hour) and standard (2- to 3-hour) infliximab infusion protocols.
Main Methods:
- A retrospective study in 3 pediatric IBD centers involving 102 children treated with infliximab.
- 63 patients were switched from standard infusions to a 1-hour rapid infusion protocol after meeting specific criteria.
- Infusion reactions were monitored and compared between the two protocols.
Main Results:
- A total of 102 children received infliximab; 63 were switched to the rapid protocol.
- Infusion reactions occurred in 11% of patients on the rapid protocol versus 15% on the standard protocol (P=0.55).
- The 1-hour protocol demonstrated comparable safety to the traditional infusion duration.
Conclusions:
- A 1-hour infliximab infusion protocol is a safe alternative for selected pediatric IBD patients.
- This rapid infusion approach aligns with findings in adult patient populations.
- Further research may support wider adoption of accelerated infusion times in pediatric care.
Abstract:
Pediatric data on rapid infliximab infusion are scarce. We report our experience with a 1-hour rapid infusion protocol, prescribed in 3 pediatric inflammatory bowel disease units during 18 to 26 months. Children treated with infliximab for inflammatory bowel disease using a standard 2- to 3-hour infusion protocol were switched to a 1-hour protocol if they had received at least 4 standard duration infusions with no infusion reactions, there was no recent dose increase and no more than 10 weeks had elapsed since the previous infusion. A total of 102 children received infliximab infusions during the study period (85 Crohn disease; mean age 14.6 ± 2.6 years) of whom 63 were switched to the rapid infusions. Seven patients on the rapid protocol (11%) and 6 patients on the standard protocol (15%) had infusion reactions (P = 0.55). Consistent with adult data, our study indicates that a 1-hour infliximab protocol in selected patients offers a safe alternative to the traditional 2- to 3-hour infusions.
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