Safety and cost benefit of an accelerated infliximab infusion protocol in the treatment of ambulatory patients with inflammatory bowel diseases

Saxena, Payal; Chen, Guang; Jideh, Bilel; Collins, G; Leong, Rupert W.

doi:10.1517/14712598.2014.866649

Cited by 16 publications

(16 citation statements)

References 15 publications

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“…Another relevant aspect of this study was the cost saving associated with the accelerated infusion. In the study of Saxena et al [25], direct costs for nursing assistance decreased of 51.1% per infusion. Our experience confirms that around 60% of the nursing and specialist cost could be saved, with relevant economic benefits for both hospitals and patients.…”

Section: Discussionmentioning

confidence: 99%

Accelerated Infliximab Infusion: Safety, Factors Predicting Adverse Events, Patients’ Satisfaction and Cost Analysis. A Cohort Study in IBD Patients

Mazzuoli

Tricarico

Demma³

et al. 2016

PLoS ONE

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BackgroundStandard Infliximab infusion consists of a 2-hour intravenous administration. Recently, Infliximab shortened infusion has been included in the Infliximab label as possible maintenance regimen for patients tolerating Infliximab induction therapy.AimTo verify if accelerated 1-hour Infliximab infusions are as safe as standard administrations, in patients with Inflammatory Bowel Disease.MethodsSeventy-four patients treated between September 2008 and November 2014 were evaluated. Patients were eligible for 1-hour infusion if they had no history of infusion reactions during the previous 2-hour infusions.ResultsTwenty-three patients received 2-hour infusions, 16 patients received 1-hour infusions, 35 patients received 2-hour infusions followed by 1-hour infusions. A total of 1,123 Infliximab infusions were administered. The proportion of patients experiencing infusion reaction was: 4% over the 1-hour infusions and 9% over the 2-hour (P = 0.318). Adverse reaction/infusion rate was 0.55% over the 1-hour infusions and 0.66% over the 2-hour (P = 0.835). In the logistic model, accelerated infusion was the only statistically significant predictor of infusion reaction risk reduction (-90%; P = 0.024). Mean satisfaction was 8/10 (±0.84) with 1-hour regimen and 6/10 (±0.56) with 2-hour infusions (P = 0.000). The mean total cost was reduced by 47% with the 1-hour regimen (133.54€ and 250.86€ for 1-hour and 2-hour infusions, respectively).ConclusionsAccelerated Infliximab infusion does not increase the acute infusion reaction incidence. In patients with inflammatory bowel disease, the 1-hour regimen should be preferred to 2-hour protocol also due to positive effects on indirect costs and patient’s satisfaction.

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Section: Discussionmentioning

confidence: 99%

Accelerated Infliximab Infusion: Safety, Factors Predicting Adverse Events, Patients’ Satisfaction and Cost Analysis. A Cohort Study in IBD Patients

Mazzuoli

Tricarico

Demma³

et al. 2016

PLoS ONE

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“…5 The use of faster infusion times with other mAbs has also been shown to reduce overall time spent receiving treatment, increase nursing satisfaction and, similarly, increase patient satisfaction. 24,25 Decreasing infusion time, therefore, has the potential to improve delivery of the drug and reduce resource utilization, while increasing patient convenience and adherence, with a low risk of IRs.…”

Section: Responsesmentioning

confidence: 99%

A phase 2 safety study of accelerated elotuzumab infusion, over less than 1 h, in combination with lenalidomide and dexamethasone, in patients with multiple myeloma

Berenson

Manges²,

Badarinath

et al. 2017

American J Hematol

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Elotuzumab, an immunostimulatory SLAMF7-targeting monoclonal antibody, induces myeloma cell death with minimal effects on normal tissue. In a previous phase 3 study in patients with relapsed/ refractory multiple myeloma (RRMM), elotuzumab (10 mg/kg, 3-h infusion), combined with lenalidomide and dexamethasone, demonstrated durable efficacy and acceptable safety; 10% (33/321) of patients had infusion reactions (IRs; Grade 1/2: 29; Grade 3: 4). This phase 2 study (NCT02159365) investigated an accelerated infusion schedule in 70 patients with newly diagnosed multiple myeloma or RRMM. The primary endpoint was cumulative incidence of Grade 3/4IRs by completion of treatment Cycle 2. Dosing comprised elotuzumab 10 mg/kg intravenously (weekly, Cycles 1-2; biweekly, Cycles 31), lenalidomide 25 mg (daily, Days 1-21), and dexamethasone (28 mg orally and 8 mg intravenously, weekly, Cycles 1-2; 40 mg orally, weekly, Cycles 31), in 28-day cycles. Premedication with diphenhydramine, acetaminophen, and ranitidine (or their equivalents) was given as in previous studies. If no IRs occurred, infusion rate was increased in Cycle 1 from 0.5 to 2 mL/min during dose 1 ( 2 h 50 min duration) to 5 mL/min for the entire infusion by dose 3 and also during all subsequent infusions ( 1-h duration). Median number of treatment cycles was six. No Grade 3/4 IRs occurred; only one Grade 1 and one Grade 2 IR occurred, both during the first infusion. These data support the safety of a faster infusion of elotuzumab administered over 1 h by the third dose, providing a more convenient alternative dosing option for patients.

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“…Indeed, shortening the infusion time is not the only difference between the fast nurse-led procedure and the standard regimens: routine premedication was abolished, post-infusion monitoring was shortened and the absence of a routine physician evaluation reduced the time of patients' initial assessment and discard. Likewise, Saxena et al recently found that 30-minutes infusions decreased direct cost of nursing by 51% per infusion [25].…”

Section: Discussionmentioning

confidence: 95%

A nurse-led accelerated procedure for infliximab infusion is well tolerated and effective in patients with inflammatory bowel disease

Michielan

Martinato

Favarin

et al. 2015

Digestive and Liver Disease

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Safety and cost benefit of an accelerated infliximab infusion protocol in the treatment of ambulatory patients with inflammatory bowel diseases

Abstract: Accelerated 30-min infliximab infusions significantly reduced nursing time, cost and increased patient satisfaction without increasing infusion reactions. Increased patient freedom and improved efficiency in healthcare delivery can be expected.

Cited by 16 publications

References 15 publications

Accelerated Infliximab Infusion: Safety, Factors Predicting Adverse Events, Patients’ Satisfaction and Cost Analysis. A Cohort Study in IBD Patients

Accelerated Infliximab Infusion: Safety, Factors Predicting Adverse Events, Patients’ Satisfaction and Cost Analysis. A Cohort Study in IBD Patients

A phase 2 safety study of accelerated elotuzumab infusion, over less than 1 h, in combination with lenalidomide and dexamethasone, in patients with multiple myeloma

A nurse-led accelerated procedure for infliximab infusion is well tolerated and effective in patients with inflammatory bowel disease

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