N002. Tolerability of shortened one-hour infliximab infusion times in IBD patients: a single-center cohort study
L. Guidi1, M. Marzo1, A. Donati1, S. Ennas1, D. Pugliese1, C. Felice1, G. Andrisani1, I. De Vitis1, G.L. Rapaccini1, A. Papa1, A. Armuzzi1, 1Internal Medicine and Gastroenterology Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
Infliximab therapy has greatly improved the management of inflammatory bowel disease (IBD), with efficacy in inducing and maintaining clinical remission. Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, requires intravenous administration in over 2 hours, with a further 1 hour of post-infusion observation. We reported our experience with shortened 1-hour infusions in IBD patients treated with infliximab with the aim to assess the safety and the tolerance of an accelerated infusion protocol and the incidence of possible infusion reactions.
This was a prospective cohort study on patients with IBD receiving infliximab with shortened 1-hour infusions. All patients were treated with scheduled maintenance infliximab therapy, with at least five well tolerated 2-hours infusions before enrolment. For each patient we recorded diagnosis, infusion number and parameters, premedication, concurrent immunosuppressor therapy, maintenance period of treatment and adverse events.
Forty-two IBD patients (24 Crohn's Disease, 18 Ulcerative Colitis) were treated with 1-hour infliximab infusion protocol at the dose of 5 mg/kg/body weight. Nine out of 42 patients (21.4%) were on concomitant immunosuppressants; thirty out of 42 patients (71.4%) were on maintenance biological treatment from more than 1 year. In total, 117 maintenance 1-hour infliximab infusions were administered. Adverse reactions were reported in 3 out of 117 (2.5%) 1-hour infusions: 2 reactions were considered as mild, allowing completion of the infusion with the standard 2-hour protocol; one reaction was considered as severe, resulting in infliximab discontinuation.
A dedicated IBD infusion unit can achieve a better quality of care in patients with inflammatory bowel disease. An accelerated 1-hour infliximab infusion was safe and well tolerated in our IBD patient cohort under scheduled maintenance therapy.