TY - JOUR T1 - Infusion Reactions Related to Infliximab Therapy Are Not Usually Associated with Drug Discontinuation JF - The Journal of Rheumatology JO - J Rheumatol SP - 1500 LP - 1502 DO - 10.3899/jrheum.120649 VL - 39 IS - 8 AU - GARRETT CULLEN AU - ADAM S. CHEIFETZ Y1 - 2012/08/01 UR - http://www.jrheum.org/content/39/8/1500.abstract N2 - Infliximab has had a major influence on the treatment of a variety of chronic inflammatory diseases since its introduction in the late 1990s and is commonly used in the management of inflammatory arthritis, inflammatory bowel disease (IBD), and psoriasis. Infliximab is administered as an intravenous infusion and, following induction therapy of 3 weight-based doses over 6 weeks, patients receive scheduled therapy every 8 weeks. A major issue for tumor necrosis factor (TNF) inhibitors is their durability. In the major trials of anti-TNF therapy in IBD, only 25% of initial responders remained in remission after 1 year. This dropoff is mostly due to a combination of secondary loss of response to the medication and adverse effects. Infusion reactions to infliximab can be alarming for patients, physicians, and nurses, and, if misunderstood, may unnecessarily limit further use of the drug. Patients who fail anti-TNF therapy may have limited treatment options, so accurate diagnosis and management of infusion reactions is vital in our attempts to fully optimize these important medications.Infusion reactions to infliximab are not uncommon, although the true incidence is difficult to estimate due to variations in the reporting of reactions, differing definitions, and issues with retrospectively collected data. In IBD, it is estimated that infusion reactions affect 5%–20% of patients and are typically mild1,2. The TREAT registry, a large post-marketing registry of patients with Crohn’s disease (CD), reported a 3.1% reaction rate in 48,279 infliximab infusions. However, reactions severe enough to limit further use of the drug occurred in only 0.07%3.In this month’s issue of The Journal, Kelsall and colleagues report their 8-year experience of infusion reactions in patients with inflammatory arthritis treated at a tertiary referral center in Vancouver, Canada4. Data were available on 4399 infliximab infusions in 200 … Address correspondence to Dr. A. Cheifetz, Center for Inflammatory Bowel Disease, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215. E-mail: acheifet{at}bidmc.harvard.edu ER -