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IBD patients at greater risk for infusion reactions with presence of infliximab antibodies
Antibodies to infliximab, a monoclonal antibody directed at Crohn’s disease and ulcerative colitis, are responsible for a much higher risk for acute infusion reactions in patients with inflammatory bowel disease, according to recent meta-analysis data.
Researchers conducted literature searches of five public databases to find studies (ie, controlled trials, observational studies, and cohort studies) that measured serum levels of antibodies to infliximab (ATIs) in patients with inflammatory bowel disease (IBD) and had recorded infusion reactions to infliximab (IFX). The analysis included eight studies and 1,351 patients.
Pooled data showed that patients receiving IFX who developed ATIs had a greater risk ratio of any acute infusion reactions (RR=2.4; 95% CI, 1.5-3.8) than patients not indicating ATIs. In three studies, ATI patients were nearly six times more likely to exhibit severe infusion reactions (RR=5.8; 95% CI, 1.7-19) than did those without ATIs.
In four studies, patients who received IFX therapy and immunomodulators showed a reduced rate in developing ATIs (RR=0.6; 95% CI, 0.4-0.9); while in two studies, patients receiving the concomitant therapies had reduced risk for acute infusion reactions (RR=0.6; 95% CI, 0.4-0.8) compared with patients not receiving immunomodulators.
“Patients on IFX therapy who develop ATIs have a 2-fold higher increased risk of acute infusion reactions, and a 6-fold higher risk of serious infusion reactions,” the researchers concluded. “Concomitant immunomodulator use reduces [ATI risk] in patients on maintenance IFX and the risk of acute infusion reactions. This has implications for the management of patients with detectable ATIs and on the development of novel biologics and biosimilars.”
Disclosure: See the study for a full list of relevant financial disclosures.