Serious Events with Infliximab in Patients with Inflammatory Bowel Disease

Abstract

Clinicians prescribing biological therapies should be aware of the development of serious events in their patients. Thorough follow-up of all patients during treatment with infliximab is warranted. If infliximab is considered in patients with IBD not responding to conventional treatment, efforts to exclude other possible underlying causes for worsening of symptoms should be made. Careful prescribing and monitoring during follow-up remains necessary.

Ten Years of Infliximab for Crohn’s Disease

“…30,32,34 More infections occurred in this series without any consequence for continuation of therapy. The true infection rate may possibly have been higher and underreported in the IBD charts.…”

“…30 The absolute percentage was comparable with other longterm studies evaluating the risk of cancer during anti-TNF therapy in IBD. 32,33 It remains difficult to assess the degree of IFX involvement in pathogenesis of neoplasia in the course of IBD. Considering the pleiotropic effects of TNF, it cannot be ruled out that IFX is related to development of any neoplasia.…”

Efficacy of TNF Antagonists Beyond One Year in Adult and Pediatric Inflammatory Bowel Diseases: A Systematic Review

“…(Table 3) Infliximab Data on long-term infliximab safety have been derived from 37 trials [7, 9, 10, 13, 17, 13, 17-24, 27, 28, 34-38, 40, 41, 44, 48-56, 58, 67-71], including 21 on patients with CD [7, 9, 10, 13, 18-20, 22-24, 27, 28, 34-38, 40, 41, 44, 67] and 9 on UC patients [48][49][50][51][52][53][54][55][56]. Seven studies reported global safety results in IBD cohorts that included both UC and CD patients, [17,21,58,[68][69][70][71] and four pediatric series reported safety issues in patients with CD [35,36] or UC [53,54]. Four studies addressed the safety issue of infliximab use as a primary analysis [67,[69][70][71].…”

“…Seven studies reported global safety results in IBD cohorts that included both UC and CD patients, [17,21,58,[68][69][70][71] and four pediatric series reported safety issues in patients with CD [35,36] or UC [53,54]. Four studies addressed the safety issue of infliximab use as a primary analysis [67,[69][70][71].…”

“…The percentage of IBD patients who experienced at least one side effect during infliximab treatment ranged from 0% [52,55] to 61.3% in the study by Van Assche et al [28] Acute infusion reactions were assessed in 23 studies [7,9,10,19,20,34,35,37,38,40,41,44,48,50,52,55,56,58,[67][68][69][70][71]; their incidence ranged between 0% [52,55] and 16% [40]. Delayed infusion reactions were evaluated in 21 studies [7,9,19,20,34,37,38,40,41,44,48,50,52,55,56,58,[67][68][69][70]…”