Tolerability of one hour 10 mg/kg infliximab infusions in inflammatory bowel diseases: A prospective multicenter cohort study

Background and Aim: In patients with inflammatory bowel disease (IBD) tolerating 2-h infusions of 5 mg/kg infliximab scheduled maintenance therapy, the infusion time can be shortened to 1-h with good tolerability. A retrospective study with small sample size demonstrated the feasibility of 1-hour infusion time for 10 mg/kg infliximab in IBD patients. Methods: Between November 2011 and July 2012, 63 patients received 1-hour 10 mg/kg infliximab infusions under standard operating procedures and were enrolled in a prospective observational study. Intravenous steroid premedication was given to all patients. Results: Sixty-three IBD patients on infliximab maintenance therapy (43 Crohn's disease, 34 males) received 1-hour 10 mg/kg infusions during the study period. A total of 182 infliximab infusions were administered. Seventeen (26%) patients were receiving concomitant immuno-modulators. Two patients experienced (2/182, 1%) severe acute infusion reactions consisting on a cutaneous lupus and one severe anaphylactic reaction. We also observed one (1/182, 0.5%) severe delayed reaction after the first 1-hour infliximab infusion consisting on acne generalis. All 3 reactions led to infliximab discontinuation. No mild acute reactions and 6 mild delayed reactions (6/182, 3%) occurred. Conclusions: In patients with IBD receiving infliximab scheduled maintenance therapy, 1-hour infusion time for 10 mg/kg infliximab seems to be well tolerated. This option might be considered in clinical practice in order to decrease the extra-burden of infliximab infusions in this patient population. (C) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.