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

PLoS One. 2016 Nov 16;11(11):e0166443. doi: 10.1371/journal.pone.0166443. eCollection 2016.

Abstract

Background: Standard 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.

Aim: To verify if accelerated 1-hour Infliximab infusions are as safe as standard administrations, in patients with Inflammatory Bowel Disease.

Methods: Seventy-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.

Results: Twenty-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).

Conclusions: Accelerated 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.

MeSH terms

  • Adult
  • Cohort Studies
  • Costs and Cost Analysis*
  • Female
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases / drug therapy*
  • Infliximab / administration & dosage*
  • Infliximab / adverse effects
  • Infliximab / economics
  • Infliximab / therapeutic use*
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Satisfaction*

Substances

  • Infliximab

Grants and funding

Merck provided funding for the editorial support of this article and to EBMA. The funder provided support in the form of salaries for authors GF and FD but had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.