title: A multicenter retrospective experience of infliximab in Crohn's disease patients: infusion reaction rates and treatment persistency.
abstract: BACKGROUND
  Infusion reactions have been associated with infliximab therapy, but no study has assessed how physicians treat and manage this common adverse event.
  
  
  OBJECTIVE
  To determine how gastroenterologists manage infusion reactions, identify prophylactic pretreatment protocols, and determine infliximab treatment persistence in the presence of infusion reactions.
  
  
  METHODS
  This retrospective multicenter chart review analyzed data from adults younger than 90 years at the time of their first infliximab infusion from 9 academic or community-based gastroenterology practices. Infusion reaction rates were compared using a Chi-square test with Yates' correction. Kaplan-Meier methods assessed infliximab treatment persistency.
  
  
  RESULTS
  Among 6,468 infusions with known infusion reaction status administered to 447 patients, 3.5% (226/6,468) of infusions resulted in an infusion reaction, and less than 0.1% (2/6,468) were associated with a serious infusion reaction. Among all patients, 19.7% (88/447) experienced at least 1 infusion reaction, whereas 0.4% (2/447) experienced a serious infusion reaction. Patients receiving concomitant immunosuppressives had fewer infusion reactions compared to patients not receiving them (57/322 patients, 17.7% vs 31/125 patients, 24.8%; P=.118). The cumulative proportion of patients continuing infliximab therapy at 2, 4, and 5 years was 73%, 58%, and 54%, respectively.
  
  
  CONCLUSIONS
  The incidence of serious infusion reactions was low. In the overall experience observed in this clinical practice retrospective cohort, no conclusions can be drawn regarding the effectiveness of specific infusion reaction prophylactic measures. In spite of infusion reactions, the long-term infliximab treatment persistence rate was high.
authors.forename: Ali
authors.initials: A
authors.lastname: Keshavarzian
authors.forename: Lloyd
authors.initials: L
authors.lastname: Mayer
authors.forename: Bruce
authors.initials: B
authors.lastname: Salzberg
authors.forename: Michael
authors.initials: M
authors.lastname: Garone
authors.forename: Warren
authors.initials: W
authors.lastname: Finkelstein
authors.forename: Joseph
authors.initials: J
authors.lastname: Cappa
authors.forename: Myron
authors.initials: M
authors.lastname: Brand
authors.forename: Jon
authors.initials: J
authors.lastname: Hain
authors.forename: David
authors.initials: D
authors.lastname: Zelinger
authors.forename: Ronald
authors.initials: R
authors.lastname: Hegedus
authors.forename: Robert H
authors.initials: RH
authors.lastname: Diamond
authors.forename: Ulka
authors.initials: U
authors.lastname: Campbell
authors.forename: Christi
authors.initials: C
authors.lastname: Lane
authors.forename: Paul
authors.initials: P
authors.lastname: Stang
authors.forename: John
authors.initials: J
authors.lastname: Watson
authors.forename: Fabio
authors.initials: F
authors.lastname: Cominelli