title: Immediate infusional reactions to intravenous immunobiological agents for the treatment of autoimmune diseases: experience of 2126 procedures in a non-oncologic infusion centre.
abstract: BACKGROUND
  With the increasing use of immunobiological drugs (IBD), the knowledge about their effectiveness and safety has increased.
  
  
  OBJECTIVE
  To analyze the immediate infusional reactions (IIR) to intravenous IBD: infliximab (IFX), rituximab (RTX), abatacept (ABT) and tocilizumab (TCZ) on the treatment of autoimmune diseases.
  
  
  METHODS
  2126 infusions performed in the Infusion Centre - CID in 268 patients were analyzed. The used drug, its clinical indication, infusion time, and use of premedication were determined by the prescribing physician. All intercurrences presented during infusion and/or during a thirty minutes observation period were considered as IIR. The approach adopted in IIR followed the protocols of the Infusion Centre - CID.
  
  
  RESULTS
  Regarding the type of IBD, the infused drugs given were: IFX (1584, 74.5%), TCZ (226, 10.63%), RTX (185, 8.7%) and ABT (131, 6,16%). IIR were described in 87 procedures (9.4%): 77 - IFX group and 10 - RTX group. IIR were not described in ABT and TCZ groups. Most were considered as mild (n = 5; 41.17%) or moderate (n = 50, 58.81%) reactions; there were no serious reactions. Regarding to discontinue infusions, 79 (92.9%) were resumed and completed successfully. Only six (0.28% of infusions) were not completed because of IIR.
  
  
  CONCLUSIONS
  Despite the differences between the number of procedures per drug, ours is a "real life" analysis, where the incidence of IIR was similar to that described in the literature. The low incidence of IIR corroborates the safety data, both quantitatively and qualitatively, and underscores the importance of specialized medical support during infusion.
authors.affiliation: Centro de Investigações Diagnósticas, Centro de Infusão, Rio de Janeiro, RJ, Brasil.
authors.forename: Ingrid Bandeira
authors.initials: IB
authors.lastname: Moss
authors.affiliation: Centro de Investigações Diagnósticas, Centro de Infusão, Rio de Janeiro, RJ, Brasil.
authors.forename: Monique Bandeira
authors.initials: MB
authors.lastname: Moss
authors.affiliation: Centro de Investigações Diagnósticas, Centro de Infusão, Rio de Janeiro, RJ, Brasil.
authors.forename: Debora Silva
authors.initials: DS
authors.lastname: dos Reis
authors.affiliation: Centro de Investigações Diagnósticas, Centro de Infusão, Rio de Janeiro, RJ, Brasil.
authors.forename: Reno Martins
authors.initials: RM
authors.lastname: Coelho
mesh_terms: D000069594:Abatacept; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage / Q000009:adverse effects; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects*; D000069285:Infliximab; D007262:Infusions, Intravenous; D015995:Prevalence; D012189:Retrospective Studies; D000069283:Rituximab; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018796:Immunoconjugates; D007155:Immunologic Factors; D000069283:Rituximab; D000069594:Abatacept; D000069285:Infliximab; C502936:tocilizumab