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Infusion of Infliximab | Predicting a Reaction in Pediatric Patients

Purpose: To determine if a pediatric patient receiving an infliximab infusion is likely to have a medically significant reaction.

Description

Infliximab is a chimeric antibody to tumor necrosis factor alpha that is used in patients with Crohn's disease and rheumatoid arthritis. Some patients develop an immune response following an infusion, resulting in an immediate or delayed reaction. Crandall and Mackner identified risk factors which could identify those patients at risk for a significant reaction. The authors are from Columbus Children's Hospital and the Ohio State University.


Mechanism: The antibody is chimeric, and involves mouse antibody. A person may already have anti-mouse antibodies, or the patient may form antibodies to the infliximab molecule.

 

Method: logistic regression

 

Patients likely to develop a medically significant reaction during the second infusion:

(1) female gender

(2) receiving no immunosuppression, OR receiving immunosuppressive medication for < 4 months

 

Patients likely to develop a medically significant reaction during the third infusion:

(1) female gender, OR a medically significant reaction during the second infusion

(2) receiving no immunosuppression, OR receiving immunosuppressive medication for < 4 months

 

Performance:

• For the predicting a reaction on the second infusion, the model was 88% accurate.

• For the predicting a reaction on the third infusion, the model was 88% accurate when the first criterion was met by female gender and 95% when met by a previous reaction.


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Specialty

Objective

ICD-10