Serum sickness, encephalitis and other complications of anti-cytokine therapy

Severe infusion reactions to infliximab: aetiology, immunogenicity and risk factors in patients with inflammatory bowel disease

“…Univariate analysis showed that patients who reacted were younger at the time of diagnosis (19 vs. 26 years, P = 0.013) and at first IFX infusion (28 vs. 35 years, P = 0.012). Furthermore, they more often received episodic therapy (72% vs. 31%, P < 0.001) and logistic regression revealed this as the only significant predictor of reactions (OR 5 [2][3][4][5][6][7][8][9][10][11][12][13]; P < 0.001). IFX reinitiation after 6 months intermission further increased the risk (OR 8 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], P < 0.001).…”

“…4 It is speculated that the reactions are caused by IFX immunogenicity. 4,5 However, little is known about the precise mechanisms including the role of anti-IFX antibodies (Ab) as well as risk factors. We aimed at investigating these factors and in particular the potential usefulness of measurements of IgG and IgE anti-IFX Ab to predict infusion reactions.…”

“…These reactions are usually associated with nausea, headache, fever, erythema and itching. 2,4,5 Acute severe infusion reactions to IFX are generally reported in about 5% of IBD patients and constitute a serious clinical problem because of the severity and the subsequent discontinuation of IFX therapy. 4 It is speculated that the reactions are caused by IFX immunogenicity.…”

“…2,4,5 Acute severe infusion reactions to IFX are generally reported in about 5% of IBD patients and constitute a serious clinical problem because of the severity and the subsequent discontinuation of IFX therapy. 4 It is speculated that the reactions are caused by IFX immunogenicity. 4,5 However, little is known about the precise mechanisms including the role of anti-IFX antibodies (Ab) as well as risk factors.…”

“…Acute infusion reactions appear in 10-40% of patients and are defined as reactions occurring during or within 1 h after infusion. [2][3][4] Delayed infusion reactions occur 1-14 days after infusion in approximately 2% of patients and are commonly associated with myalgias, arthralgias, headache, fever, rash and fatigue. 2,4 Acute reactions can be further categorised as mild, moderate or severe; the latter occurring shortly after start of infusion necessitating immediate stop of the infusion due to ex.…”