Infliximab Reintroduction is Not Associated to a Higher Rate of Immune-related Adverse Effects in Patients With Inflammatory Bowel Disease Initially Treated With a Three-infusion Induction Regimen

Background: Episodic infliximab (IFX) treatment is associated with a higher risk for acute infusion reactions (AIR) and secondary loss of response (SLR), but this has not been evaluated in patients initially treated with an induction regimen with 3 IFX infusions. Aims: To evaluate whether IFX reintroduction after >= 4 months in patients treated with a 3-infusion induction regimen is associated with a higher incidence of AIR or SLR. Methods: Incidence of immunogenic adverse effects was assessed in patients with inflammatory bowel disease who received >= 4 consecutive IFX infusions (3 infusions at weeks 0, 2, and 6, plus >= 1 maintenance infusion) (Continuous, n = 47) and patients who were treated with a successful initial 3-infusion induction scheme and in whom IFX was then discontinued because of a complete response but reintroduced >= 4 months later (Reintro, n = 29). Results: AIR rate was 17% in both groups, and SLR rate was 26% in the Continuous group and 15% in the Reintro group (not significant). The lack of concomitant immunomodulators and/or pretreatment with hydrocortisone were associated with AIR development (P = 0.002). Conclusions: In patients who completed a 3-infusion induction regimen, IFX can be safely reintroduced even after a long time from discontinuation.