Premedications for infliximab infusions do not impact the risk of acute adverse drug reactions
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OBJECTIVE: The purpose of this study was to identify the association of premedication with the adverse drug reaction (ADR) rate in infliximab infusions. DESIGN: A retrospective chart review of 684 patients who received 4077 infusions in a network of community clinics over 16.5 months. Data collected included age, weight, sex, diagnosis, dose, premedications and ADR information, which was coded for time of onset, severity and outcome. SETTING: Community infusion clinics located in Ontario, Canada. PATIENTS: Patients aged 12-91 years who receive regular infliximab infusions to treat their autoimmune condition, mainly either Crohn's disease or rheumatoid arthritis. MAIN OUTCOME MEASURES: The number of infusions to the occurrence of an acute ADR by presence of premedication. RESULTS: ADRs are not significantly different (χ2(1, n=644, p=0.651)=0.204) between those who always received premedications and those who never did. When controlling for age, sex, weight and diagnosis, patients receiving premedications were just as likely to experience an ADR as patients who never received any (OR 1.1, 95% CI 0.7 to 1.9, p=0.5). When assessing the number of infusions to the occurrence of an ADR using the Kaplan-Meier method, no significant difference was found between the two groups. CONCLUSIONS: The use of premedications is not associated with a decreased risk of ADR in patients receiving infliximab. This held true for patients who had never had an ADR prior to receiving premedications and while controlling for age, sex, weight and diagnosis.