Safety of Rapid Infliximab Infusions in Children

Abstract

Objectives: The aim of the study was to assess whether the incidence of infusion reactions (IR) increases after rapid (≤1 hour) infliximab (IFX) infusions, compared with standard (2–3 hour) infusions in children. Methods: Systematic review including studies describing the number of IR after rapid IFX infusion in children ages 0 to 18 years. Results: Four records were included (3 retrospective, n = 498, 347 standard infusions, 3703 rapid infusions). Reported incidences of IR ranged from 0% to 2% of infusions in standard groups (reported 95% confidence intervals [CIs] ranged from 0% to 7%) and from 0% to 2% of infusions in rapid groups (reported 95% CIs ranged from 0% to 12%). None of the studies included reported a significant difference in incidence of IR between the 2 groups. Conclusions: There is insufficient evidence to conclude whether the rate of IR after rapid IFX increases. The consistent finding of no increase in IR in all studies and the low rate of observed IR suggests there is no significant difference in rate of IR.

Rapid Infliximab Biosimilar Infusion in Children With Inflammatory Bowel Disease

“…This is the first report showing rapid infusion of IFX‐abda is well tolerated without an apparent increase in IRs compared with IFX while providing significant cost savings and health care efficiencies. The overall prevalence of IRs in this study (2.6% with all subjects and 1% with outlier excluded) are consistent with prior published risks of IRs in multiple adult and pediatric cohorts (9,10). The variability of IRs between the standard and rapid rates could be attributed to the usual practice of receiving the first 3 infusions at a standard rate.…”

“…A 2013 meta‐analysis found a decreased risk of IRs favoring rapid infusions (9). A 2020 systematic review of 4 pediatric rapid IFX infusion studies compiled 498 individuals and over 4000 infusions revealed IR rate of 0% to 2% in standard and 0% to 2% in rapid infusion (10). This review noted the relatively small number of subjects in the setting of low incidence of IRs, which led the authors to state there was insufficient evidence to draw firm conclusions about the safety of rapid IFX infusions in children.…”

Safety of Accelerated Infliximab Infusions in Children With Inflammatory Bowel Disease: A Retrospective Cohort Study

“…Pediatric data also found no differences in the occurrence of IR between accelerated and standard infusions (17–20). These studies, however, included small numbers of patients who mainly switched to accelerated infusion after tolerating standard infusions (21). Moreover, it remains largely unknown whether an intrahospital observation period after accelerated infusion is indicated.…”

Rapid Infliximab Infusions in Paediatric Inflammatory Bowel Disease Patients, a Single Hospital Experience

“…To the Editor: We have read with interest the systematic review by Van Wassenaer et al (1), describing the use and safety of rapid infliximab (IFX) infusions (RII) in paediatric patients, showing that there is not an increase in associated infusion reactions.…”