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Infliximab desensitization reduces allergic reactions in patients with inflammatory bowel disease

Desensitization may be successful in limiting the severity of adverse reactions people with inflammatory bowel disease experience when using infliximab, according to study results.

“Most patients who developed reactions to infliximab benefited from desensitization and continued to receive their effective treatment without significant adverse effect,” Ahmad A. Mourad, MD, of the allergy and immunology section at Louisiana State University Health, and colleagues wrote.

Mourad and colleagues conducted a single-center, retrospective study of 336 patients with inflammatory bowel disease to determine the frequency and characteristics of adverse reactions to infliximab (Remicade, Janssen Biotech).

Thirty patients (9%) developed systemic adverse reactions to infliximab. Thirty-seven percent of patients reported upper and lower respiratory symptoms as well as urticaria and angioedema as the most common reported adverse reactions.

Patients did not experience an adverse reaction after the first administration of infliximab (0.01 mg), however patients started experiencing adverse reactions after additional doses.

Forty percent reacted after one to three doses, 33% after four to eight doses and 27% after more than eight doses.

Half of the patients who developed adverse reactions discontinued infliximab and switched to other medications.

Forty percent of patients underwent desensitization and received the recommended therapeutic dose. The procedure lasted 4 to 6 hours and only some patients developed mild adverse reactions during desensitization. The researchers treated the reactions by slowing the infusion rate and occasionally administering antihistamines.

No reaction required the desensitization to stop and no reaction required administering corticosteroid or epinephrine.

“Although the desensitization procedure requires several hours, [previous studies] point to its advantage in allowing patients who respond well to infliximab but develop adverse reactions to continue the medication,” the researchers wrote. – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.