Infliximab administered with shortened infusion times in a specialized IBD infusion unit: a prospective cohort study.

BACKGROUND AND AIMS Biological therapy with anti TNF agents requires parenteral administration and in the case of infliximab this involves in hospital treatment. We aimed to prospectively assess the safety and tolerance of infliximab infusion in patients with IBD in a specialized unit adhering to strict standard operation procedures including switch to accelerated 1h infusions. METHODS A prospective audit of a referral center IBD infusion unit was performed. We recorded infusion times and all adverse events including hypersensitivity reactions. Patients were also polled about the impact of the treatment on quality of life (QOL). RESULTS On 20 consecutive days 177 patients were treated with infliximab and all participated. Of those infliximab 117 received 1h infusions and 4 (2.2%) had an immediate infusion reaction. Median time on unit was optimal for those with 1h infusions [1:35 h (IQR: 1:25-1:50)] without an increased risk of infusion reactions. Prophylactic therapy significantly increased the time on unit [3:20 h (IQR: 2:50-3:45), p<0.001]. Patients reported a high global satisfaction and a good tolerability of the infusions with a considerable or strong impact on studies, work or QOL in one third. CONCLUSIONS A dedicated IBD infusion unit can achieve high quality of care and shortened 1h infliximab infusions are well tolerated in patients with scheduled maintenance therapy.