Abstract
Objective: Accelerated infliximab (IFX) infusions were officially approved by the Health and Labor Ministry of Japan in May 2012. Since May 2006, IFX infusion times have been shortened in some patients with arthritis who have not experienced any adverse infusion reactions (IR) from the standard 120-minute infusion time. In this study, the tolerability of shortened IFX infusion times from over the six years of experience was investigated.
Methods: Patients with arthritis who completed an IFX infusion without any IR on at least five 120-minute infusion occasions were allowed to shorten their infusion times. Infusion times were gradually shortened to 90, 60, and 30 minutes with a primary goal of 60 minutes. Anti-allergy medication was not used routinely. The infusions were conducted in the outpatient chemotherapy treatment facility.
Results: Among 71 outpatients with arthritis (58 females and 13 males), 69 had rheumatoid arthritis, 1 had psoriatic arthritis, and 1 had ankylosing spondylitis treated with IFX; 13, 29 and 11 patients received 90-minute, 60-minute and 30-minute infusions, respectively. There were 23 observed infusion reactions among 1,787 infusions of IFX (incidence rate: 1.29%). With respect to infusion time, seventeen cases of IR occurred in the 120-minute (73.9%), four in the 90-minute (17.4%), one in the 60-minute (4.3%) and one in the 30-minute (4.3%) infusion periods, respectively. Three cases of IR occurred when the dose of IFX was increased and five when the infusion time was shortened. However, all the symptoms of IR were minor and the infusions were safely completed by extending the infusion time and/or using anti-allergy medication.
Conclusion: The infusion time of IFX can be safely shortened to just 30 minutes by following proper protocols and maintaining close observation, for the convenience of patients.
