P534 Risk factors for infusion reactions of infliximab in patients with Crohn’s disease
Y. Inaba*1, M. Taruishi1, M. Fujiya2, Y. Saitoh1
1Asahikawa City Hospital, Gastroenterology, Asahikawa, Japan, 2Asahikawa Medical University, Internal Medicine, Asahikawa, Japan
Infliximab is an anti-tumour necrosis factor-α chimeric monoclonal antibody that is an established treatment for Crohn’s disease. Reactions during or within 2 hours of infusions are defined as infusion reactions. Thus, the recommended administration of a 2-hour infusion followed by 2 hours of monitoring is practised because of the potential occurrence of them. The aim of this study was to identify risk factors for infusion reactions by infliximab treatment in patients with Crohn’s disease in clinical practice.
A retrospective case note and pharmacy database review was conducted regarding the infusion of infliximab administered to patients with Crohn’s disease at Asahikawa Medical University.
Infliximab was administered to 94 patients between 2002 and 2014. The incidence of infusion reactions was 50.0% (n = 47), and severe acute reactions occurred in 11.7% (n = 11) of the patients who received the infusions. Thirty-six patients (38.3%) received either a concomitant systemic steroid or H1 blocker treatment before the start of the infliximab infusion. The mean age of the patients with an infusion reaction was 29.4 years (range, 14–46 years) compared with a mean age of 34.3 years (range, 14–72) for those patients without infusion reactions (p = 0.009, Fisher’s exact test). Patients who exhibited an infusion reaction comprised 80.9% of the cases with the ileo-colitis disease type, whereas only 53.2% of the patients without an infusion reaction also had the ileo-colitis disease type (p = 0.004, Fisher’s exact test). There were no differences in the incidences of infusion reactions between the patients who were or were not administered an immune-modulator. And risk factors for infusion reactions according to Cox proportional hazards analysis were elder patient (increase per year; HR 0.94; 95% CI 0.91 to 0.99; p = 0.01), the non-ileo-colitis disease type (HR 0.50; 95% CI 0.24 to 0.99; p = 0.04).
The clinical data from the 94 patients treated with infliximab demonstrate that infusion reactions frequently occur and are mostly mild to moderate in presentation. The incidence of infusion reaction was thus found to be significantly associated with the patient age and disease type. Identification of the risk factors for infusion reactions of infliximab therapy should help to minimise such events in Crohn’s disease.