Infliximab Infusion Reactions: Desensitizing Ourselves to the Danger

Persley, Kimberly M.

doi:10.1097/00054725-200401000-00011

Cited by 8 publications

(5 citation statements)

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“…Thus, it has been proposed to eliminate the term 'hypersensitivity' when describing infliximab infusion reactions. 26 So far, the mechanism of desensitization is not known but it might not involve mediator depletion (histamine) or tachyphylaxis. 23 Postulated mechanisms include production of competing/blocking IgG antibodies, univalent hapten carrier proteins inhibiting IgE cross-linking on mast cells, or possible intracellular signalling inhibition in the mast cell triggered by lowdrug concentrations.…”

Section: Discussionmentioning

confidence: 99%

Successful induction of tolerance to infliximab in patients with Crohn's disease and prior severe infusion reactions

Duburque¹,

Lelong

Iacob

et al. 2006

Aliment Pharmacol Ther

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SUMMARY AimTo appraise the tolerance and efficacy of an induction of tolerance protocol to infliximab permitting the re-administration of the drug to patients with Crohn's disease having had infusion reactions requiring suspension of treatment. MethodsFourteen patients were included in the induction of tolerance protocol. Each infusion of infliximab (5 mg/kg) was divided into 11 escalating 15 min increments over a 3-h time period. The induction of tolerance procedure was repeated for subsequent infusions. ResultsTen patients (71.4%) received all the three infusions for the induction treatment. Nine (64.3%) had a significant response and six (48.8%) still benefited from infliximab infusions. Seven patients (50%) achieved a complete remission, after a mean of 2.5 (two to three) infusions. Four patients (28.6%) had no response and the protocol was stopped. Three patients (21.4%) experienced mild immediate hypersensitivity reactions, which were controlled, two patients (14.2%) experienced severe immediate hypersensitivity reactions, leading to interruption of the treatment and one patient developed a delayed hypersensitivity reaction. ConclusionOur induction of tolerance protocol allows some patients who have experienced severe or repetitive infusion reactions to infliximab to be safely retreated with the drug in a hospitalized setting, with a clinical response achieved in a majority of these patients.

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Section: Discussionmentioning

confidence: 99%

Successful induction of tolerance to infliximab in patients with Crohn's disease and prior severe infusion reactions

Duburque¹,

Lelong

Iacob

et al. 2006

Aliment Pharmacol Ther

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“…[13][14][15] Infusion reactions have been consistently documented with the intravenous administration of infliximab. 11,[16][17][18][19][20] Measurable serum concentrations of anti-infliximab antibodies are detected in most patients who present with infusion related reactions. 15,21 Adverse events occurring during the infusion or in the first 24 hours following the infusion are defined as acute reactions, whereas those manifesting 24 hours to 14 days postinfusion are considered to be delayed-type reactions.…”

Section: Infusion Reactionsmentioning

confidence: 99%

“…In most cases, reduction of infusion rate leads to the resolution of the symptoms. 17 The pathogenic mechanism underlying the vast majority of these reactions is considered to be of a nonimmune-mediated type, rather than a true anaphylactic response. 14,18 Therefore, in cases of mild or moderate infusion reactions, the drug has been subsequently re-administered under certain routine prophylactic measures, such as premedication with antihistamines and/or corticosteroids and adjustment of the infusion rate.…”

Section: Infusion Reactionsmentioning

confidence: 99%

Cutaneous side effects of anti–tumor necrosis factor biologic therapy: A clinical review

Moustou

Matekovits

Dessinioti

et al. 2009

Journal of the American Academy of Dermatology

172

108

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“…The incidence of infusion reactions and the outcome of specific treatment protocols have been evaluated in a large cohort of infliximab-treated patients with Crohn’s disease [5, 6]. Acute infusion reactions were defined as adverse events occurring at the time of the infusion and up to 24 h later, in contrast to delayed-type infusion reactions that occur more than 24 h after the infusion.…”

Section: Tnf-α Metabolic Pathway: Infliximab Etanercept and Adalimumabmentioning

confidence: 99%

“…5% of all infusions). Based upon the physician assessment of the vital signs and symptoms (including cutaneous manifestations, fever, chest pain, hypo/hypertension or dyspnoea), they are classified as mild, moderate or severe types and concern 3.1, 1.2 and 1% of the infusions, respectively [5, 6]. …”

Section: Tnf-α Metabolic Pathway: Infliximab Etanercept and Adalimumabmentioning

confidence: 99%

Cutaneous Adverse Events of Biological Therapy for Psoriasis: Review of the Literature

Thielen¹,

Kuenzli²,

Saurat³

2005

Dermatology

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The use of biological agents is expanding worldwide as a new treatment alternative for chronic inflammatory diseases including more recently skin diseases, especially psoriasis. Although frequently observed, the knowledge about acute and chronic dermatological adverse events is limited, and potential pathogenic mechanisms still have to be identified. Exact diagnosis is required considering that dermatological adverse events raise a decisional challenge about potential treatment discontinuation. The object of this publication is to present an overview of the dermatological adverse events of these new treatment alternatives.

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Infliximab Infusion Reactions: Desensitizing Ourselves to the Danger

Cited by 8 publications

References 0 publications

Successful induction of tolerance to infliximab in patients with Crohn's disease and prior severe infusion reactions

Successful induction of tolerance to infliximab in patients with Crohn's disease and prior severe infusion reactions

Cutaneous side effects of anti–tumor necrosis factor biologic therapy: A clinical review

Cutaneous Adverse Events of Biological Therapy for Psoriasis: Review of the Literature

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