Infusion reactions to infliximab in children and adolescents: frequency, outcome and a predictive model

BACKGROUND: Crohn's disease commonly affects children and adolescents, however the majority of research into the safety and efficacy of therapies for inflammatory bowel disease, including infliximab, has occurred only in adults. AIM: To determine the rate of reactions in children following infliximab infusions, and to identify variables that might be predictive of those reactions. METHODS: We performed a retrospective review of all infliximab infusions performed at Columbus Children's Hospital from December 1998 through September 2001. RESULTS: Fifty-seven children received 361 infusions. Three hundred and fifty-five of the 361 infusions (98.3%) were completed. Fifty children had 304 repeat infusions. There were a total of 35 infusion related reactions. Female gender and the use of immunosuppressive medications for less than 4 months were risk factors for a reaction to infusion number 2. A reaction to infusion 2 and immunosuppressive use for less than 4 months were risk factors for infusion number 3. CONCLUSIONS: The rate of infusion reactions in children receiving infliximab is similar to that in adults. Female gender, immunosuppressive use for less than 4 months and prior infusion reactions may be risk factors for subsequent infusion reactions in children.