PT  - JOURNAL ARTICLE
AU  - Florence A.  Aeschlimann
AU  - Kevin D.  Hofer
AU  - Elvira  Cannizzaro Schneider
AU  - Silke Schroeder
AU  - Roger Lauener
AU  - Rotraud K.  Saurenmann
TI  - Infliximab in Pediatric Rheumatology Patients: A Retrospective Analysis of Infusion Reactions and Severe Adverse Events During 2246 Infusions over 12 Years
AID  - 10.3899/jrheum.131231
DP  - 2014 May 15
TA  - The Journal of Rheumatology
PG  - jrheum.131231
4099  - http://www.jrheum.org/content/early/2014/05/12/jrheum.131231.short
4100  - http://www.jrheum.org/content/early/2014/05/12/jrheum.131231.full
AB  - Objective To describe infusion reactions (IR) and severe adverse events (SAE) associated with infliximab (IFX) in pediatric patients with rheumatologic and ocular inflammatory diseases in a real-world setting. Methods This is a retrospective chart review of all patients treated with IFX at the pediatric rheumatology division of a university hospital between October 2000 and December 2012. Results A total of 2446 IFX infusions were given to 82 patients (72% female). IR occurred in 46 infusions (2%) of 14 patients (17%) after a mean IFX treatment time of 340 days (range 41–780); 9/14 patients (64%) experienced repeated IR. IR were classified as mild (26%), moderate (74%), or severe (0%). Indications for IFX were arthritis (60%), uveitis (20%), arthritis and uveitis (13%), and other inflammatory diseases (5%). The most common clinical symptoms were respiratory signs (72%), cutaneous manifestations (69%), and malaise (61%). In 6/14 patients (43%) with IR, IFX was discontinued: 4 patients because of repeated IR and 2 patients wished to stop treatment immediately following a mild IR. The other 8/14 patients (57%) received premedication with high-dose antihistamine (100%), corticosteroids (75%), and IFX dose increase (75%) and continued IFX treatment for a mean followup period of 146 weeks (range 26–537) after the first IR. We observed severe infections in 5/82 patients (6%); other SAE were rare. Conclusion Mild and moderate IR occurred in 17% of our patients. Treatment with antihistamines and methylprednisolone, and increasing the IFX dose, allowed continued treatment despite IR in > 50% of patients. Other SAE were infrequent.