[Reactions to infliximab infusions in dermatologic patients: consensus statement and treatment protocol. Working Group of the Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología ].
Infliximab is a chimeric monoclonal antibody that binds to and blocks tumor necrosis factor alpha and is the most effective biologic agent approved for the treatment of moderate-to-severe psoriasis. It is administered by intravenous infusion, usually in day hospitals on an outpatient basis. The main problem with the administration of infliximab is the possibility of infusion reactions, which may be immediate or delayed; these reactions are related to the immunogenicity of this monoclonal antibody, leading to the production of anti-infliximab antibodies. Infusion reactions to infliximab are not usually anaphylactic (ie, they are not mediated by immunoglobulin E), and re-exposure of the patient using specific protocols to prevent and treat these reactions is therefore possible. The extensive experience in the use of infliximab for the treatment of rheumatic conditions and chronic inflammatory bowel disease has made it possible to develop infusion reaction management protocols; these can be applied to dermatologic patients, who constitute a growing proportion of patients treated with intravenous biological agents. The aim of this review is to draw up a consensus protocol for the treatment of infusion reactions in dermatologic patients treated with infliximab.
Puig Sanz
Lluís
L
Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España. Lpuig@santpau.cat
Sáez
E
E
Lozano
M J
MJ
Bordas
X
X
Carrascosa
J M
JM
Gallardo
F
F
Luelmo
J
J
Sánchez-Regaña
M
M
Alsina
M
M
García-Patos
V
V
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000096:biosynthesis; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D001168:Arthritis / Q000209:etiology; D002985:Clinical Protocols; D000075202:Contraindications; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000209:etiology / Q000451:nursing / Q000517:prevention & control / Q000628:therapy*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D011565:Psoriasis / Q000188:drug therapy* / Q000451:nursing; D012008:Recurrence; D012131:Respiratory Insufficiency / Q000209:etiology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000305:Adrenal Cortex Hormones; D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D006633:Histamine Antagonists; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab