Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease
Infliximab (IFX) is a recombinant DNA-derived chimeric IgG monoclonal antibody protein that inhibits tumor necrosis factor alpha (TNF-α). IFX, like other agents derived from foreign proteins, can cause infusion reactions both during and after the infusion. The incidence of infusion reactions ranges...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-11-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/11/11/1366 |
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| author | Rajmohan Dharmaraj Tess Pei Lemon Rasha Elmaoued Ricardo Orlando Castillo Razan Alkhouri |
| author_facet | Rajmohan Dharmaraj Tess Pei Lemon Rasha Elmaoued Ricardo Orlando Castillo Razan Alkhouri |
| author_sort | Rajmohan Dharmaraj |
| collection | DOAJ |
| description | Infliximab (IFX) is a recombinant DNA-derived chimeric IgG monoclonal antibody protein that inhibits tumor necrosis factor alpha (TNF-α). IFX, like other agents derived from foreign proteins, can cause infusion reactions both during and after the infusion. The incidence of infusion reactions ranges between 0% and 15% in pediatric patients. The potential underlying mechanisms for these reactions may include anaphylaxis and anaphylactoid reactions, cytokine release syndrome, serum sickness-like reactions, and the development of antibodies against IFX. Several precautions can help reduce the risk of a new infusion reaction, such as a gradual increase in the infusion rate, scheduled infusions, and administering premedication or immunomodulators alongside IFX. Acute mild to moderate reactions often resolve spontaneously after a temporary cessation of the infusion or reduction in the infusion rate. Strategies like graded dose challenges and premedication can be utilized to prevent recurrence. In cases of severe reactions, desensitization or switching to an alternative biologic may be considered. This article aims to review the most recent guidelines for managing IFX-related infusion reactions in pediatric patients with inflammatory bowel disease (IBD), relying on the best available evidence. |
| format | Article |
| id | doaj-art-ea41ef5345ab49f394deb042e20a571c |
| institution | OA Journals |
| issn | 2227-9067 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-ea41ef5345ab49f394deb042e20a571c2025-08-20T02:08:09ZengMDPI AGChildren2227-90672024-11-011111136610.3390/children11111366Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel DiseaseRajmohan Dharmaraj0Tess Pei Lemon1Rasha Elmaoued2Ricardo Orlando Castillo3Razan Alkhouri4Division of Gastroenterology, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USADivision of Gastroenterology, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USADivision of Gastroenterology, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USADivision of Gastroenterology, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USADivision of Gastroenterology, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USAInfliximab (IFX) is a recombinant DNA-derived chimeric IgG monoclonal antibody protein that inhibits tumor necrosis factor alpha (TNF-α). IFX, like other agents derived from foreign proteins, can cause infusion reactions both during and after the infusion. The incidence of infusion reactions ranges between 0% and 15% in pediatric patients. The potential underlying mechanisms for these reactions may include anaphylaxis and anaphylactoid reactions, cytokine release syndrome, serum sickness-like reactions, and the development of antibodies against IFX. Several precautions can help reduce the risk of a new infusion reaction, such as a gradual increase in the infusion rate, scheduled infusions, and administering premedication or immunomodulators alongside IFX. Acute mild to moderate reactions often resolve spontaneously after a temporary cessation of the infusion or reduction in the infusion rate. Strategies like graded dose challenges and premedication can be utilized to prevent recurrence. In cases of severe reactions, desensitization or switching to an alternative biologic may be considered. This article aims to review the most recent guidelines for managing IFX-related infusion reactions in pediatric patients with inflammatory bowel disease (IBD), relying on the best available evidence.https://www.mdpi.com/2227-9067/11/11/1366infiximabinfusion reactionchildrenpreventionmanagement |
| spellingShingle | Rajmohan Dharmaraj Tess Pei Lemon Rasha Elmaoued Ricardo Orlando Castillo Razan Alkhouri Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease Children infiximab infusion reaction children prevention management |
| title | Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease |
| title_full | Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease |
| title_fullStr | Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease |
| title_full_unstemmed | Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease |
| title_short | Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease |
| title_sort | infusion reactions to infliximab in pediatric patients with inflammatory bowel disease |
| topic | infiximab infusion reaction children prevention management |
| url | https://www.mdpi.com/2227-9067/11/11/1366 |
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