Accelerated Infliximab Infusion: Safety, Factors Predicting Adverse Events, Patients’ Satisfaction and Cost Analysis. A Cohort Study in IBD Patients

Abstract

BackgroundStandard Infliximab infusion consists of a 2-hour intravenous administration. Recently, Infliximab shortened infusion has been included in the Infliximab label as possible maintenance regimen for patients tolerating Infliximab induction therapy.AimTo verify if accelerated 1-hour Infliximab infusions are as safe as standard administrations, in patients with Inflammatory Bowel Disease.MethodsSeventy-four patients treated between September 2008 and November 2014 were evaluated. Patients were eligible for 1-hour infusion if they had no history of infusion reactions during the previous 2-hour infusions.ResultsTwenty-three patients received 2-hour infusions, 16 patients received 1-hour infusions, 35 patients received 2-hour infusions followed by 1-hour infusions. A total of 1,123 Infliximab infusions were administered. The proportion of patients experiencing infusion reaction was: 4% over the 1-hour infusions and 9% over the 2-hour (P = 0.318). Adverse reaction/infusion rate was 0.55% over the 1-hour infusions and 0.66% over the 2-hour (P = 0.835). In the logistic model, accelerated infusion was the only statistically significant predictor of infusion reaction risk reduction (-90%; P = 0.024). Mean satisfaction was 8/10 (±0.84) with 1-hour regimen and 6/10 (±0.56) with 2-hour infusions (P = 0.000). The mean total cost was reduced by 47% with the 1-hour regimen (133.54€ and 250.86€ for 1-hour and 2-hour infusions, respectively).ConclusionsAccelerated Infliximab infusion does not increase the acute infusion reaction incidence. In patients with inflammatory bowel disease, the 1-hour regimen should be preferred to 2-hour protocol also due to positive effects on indirect costs and patient’s satisfaction.

Subcutaneously-Administered Infliximab in the Management of Rheumatoid Arthritis: A Short Narrative Review of Current Clinical Evidence

“…The SC administration may potentially offer convenience for the healthcare system, optimizing the organizational impact due to the preparation and administration of the IV infusion, allowing resources to be used more efficiently, and reducing direct costs associated with the infusion, which in Italy were quantified at around 156 euros for a standard infusion of 2 hours. 30 …”

Budget Impact Analysis of the Subcutaneous Infliximab (CT-P13 SC) for Treating Inflammatory Bowel Disease in the EU-5 Countries

“…The mean total cost was €250.86 for a standard 2-hour infusion and €133.54 for a 1-hour infusion. This compares with an estimated IV administration cost of £298 (around €348) in the UK based on a technology appraisal by the National Institute of Health and Care Excellence [23,24]. The largest driver of costs was time spent by nurses and specialists administering treatment and monitoring the patient after the infusion, accounting for almost 90% of all costs [23].…”

“…IV treatment imposes a nancial burden, through resource use (equipment, outpatient bed space) and healthcare professional (HCP) time to prepare or administer infusions [22]. A study in Italy investigated the inpatient costs associated with a single infusion of in iximab in patients with IBD [23]. The mean total cost was €250.86 for a standard 2-hour infusion and €133.54 for a 1-hour infusion.…”

A quality improvement project reduces time spent at an inflammatory bowel disease infusion center with accelerated infliximab infusion protocol

“…[10][11][12] Furthermore, accelerated infliximab infusions have been shown to reduce significantly nursing time, healthcare resources, and increase patient satisfaction. [13][14][15][16] Given the safety and benefits of accelerated infliximab infusion protocol, our IBD center developed a quality improvement (QI) project to shorten the average time spent at the outpatient biologics infusion center. The primary aim of this QI project was to reduce by 40%, both the average infliximab infusion time and the total time spent at the outpatient biologics infusion center.…”

“…Short infusion (over 30–60 min) protocols have been found safe in patients with rheumatoid arthritis and IBD 10–12 . Furthermore, accelerated infliximab infusions have been shown to reduce significantly nursing time, healthcare resources, and increase patient satisfaction 13–16 …”