Infusion reactions to infliximab in children and adolescents: frequency, outcome and a predictive model.
BACKGROUND
Crohn's disease commonly affects children and adolescents, however the majority of research into the safety and efficacy of therapies for inflammatory bowel disease, including infliximab, has occurred only in adults.


OBJECTIVE
To determine the rate of reactions in children following infliximab infusions, and to identify variables that might be predictive of those reactions.


METHODS
We performed a retrospective review of all infliximab infusions performed at Columbus Children's Hospital from December 1998 through September 2001.


RESULTS
Fifty-seven children received 361 infusions. Three hundred and fifty-five of the 361 infusions (98.3%) were completed. Fifty children had 304 repeat infusions. There were a total of 35 infusion related reactions. Female gender and the use of immunosuppressive medications for less than 4 months were risk factors for a reaction to infusion number 2. A reaction to infusion 2 and immunosuppressive use for less than 4 months were risk factors for infusion number 3.


CONCLUSIONS
The rate of infusion reactions in children receiving infliximab is similar to that in adults. Female gender, immunosuppressive use for less than 4 months and prior infusion reactions may be risk factors for subsequent infusion reactions in children.
Crandall
W V
WV
Section of Pediatric Gastroenterology and Nutrition, Columbus Children's Hospital, 700 Children's Drive, Columbus, OH 43205-2696, USA. crandallw@pediatrics.ohio-state.edu
Mackner
L M
LM
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002648:Child; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D004347:Drug Interactions; D004417:Dyspnea / Q000139:chemically induced; D005260:Female; D005483:Flushing / Q000139:chemically induced; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D000069285:Infliximab