[Rapid application of infliximab. Efficacy and complications]

Abstract

Objective: To compare the clinical safety of the rapid infusion of infliximab (30-45 min) with the traditional one (2 h).

Patients and method: Open, prospective study with the consecutive inclusion of 150 patients with rheumatoid arthritis (RA) and/or spondyloarthritis (AS), resistant to conventional treatment. Patients were randomly distributed to receive 1.5 or 3 mg/kg (according to medical criteria) into 2 groups of 75 patients. Group A: patients received a rapid infusion of infliximab (30-45 min) and group B: traditional intravenous infusion (2 h). The rhythm of infusion was regulated through drip counts and the rule of threes and time was counted on a digital chronometer. Data was obtained from all patients included on possible side effects, as well as efficacy parameters (visual analog scale for pain, tender, and swollen joint counts), and comparisons were made between the rapid infusion group and the traditional infusion group.

Results: All patients concluded the study without serious complications. In the rapid infusion group 3 patients had hypersensitivity in the infusion arm and erythema was present in 7 more. The presence of side effects was not significantly different in relation with the infusion speed. Differences were not found in relation to the dosage or the type of illness (RA and/or AS) either. The efficacy of Infliximab for symptom control showed no differences using both types of infusion.

Conclusions: The absence of noticeable secondary effects associated with the reduction in the time of infusion of infliximab permits us to point out that a reduction in the time of infusion of infliximab can be a method to optimize hospital resources concerning the outpatient clinic for biologic therapy.