The impact of infliximab infusion reactions on long-term outcomes in patients with Crohn’s disease A. C. MOSS*, N. FERNANDEZ-BECKER*, K. JO KIM, D. CURY & A. S. CHEIFETZ Harvard Medical School, Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA Correspondence to: Dr A. C. Moss, Center for Inflammatory Bowel Disease, Rose 1 / East, BIDMC, 330 Brookline Ave, Boston, MA 02215, USA. E-mail: amoss@bidmc.harvard.edu *Both authors contributed equally to this work. Publication data Submitted 7 April 2008 First decision 24 April 2008 Resubmitted 7 May 2008 Accepted 7 May 2008 Epub OnlineAccepted 12 May 2008 SUMMARY Background Little is known about long-term outcomes in patients who experience infusion reactions while receiving infliximab. Aim To investigate long-term outcomes in patients who experience infusion reactions while receiving infliximab. Methods Retrospective electronic chart review of long-term clinical outcomes. Results Clinical data on 287 patients who received infliximab infusions for Cro- hn’s disease were reviewed, of whom 51 developed at least one infusion reaction (18%). Ileo-colonic disease (OR 2.2, 95% CI 1.1–4.4) and epi- sodic infliximab (OR 2.4, 95% CI 1.2–4.7) were associated with a higher risk of infusion reactions in univariate analysis, but concomitant azathi- oprine / mercaptopurine therapy at the initiation of infliximab was asso- ciated with a reduced risk (OR 0.4, 95% CI 0.2–0.8). Only the effect of concomitant immunomodulators persisted on multivariate analysis. Patients who experienced infusion reactions were less likely to be in remission at 1 year (OR 0.6, 95% CI 0.3–1.2), 2 years (OR 0.4, 95% CI 0.2–0.8, P = 0.01), or 5 years (OR 0.4, 95% CI 0.1–1.3) and more likely to require surgery (OR 2.2, 95% CI 1.1–4.1, P = 0.01) than those who did not experience such reactions. Conclusions Patients who experienced infusion reactions to infliximab had a high rate of discontinuation of therapy in this cohort. Concomitant immuno- modulators and maintenance therapy reduced the risk of infusion reac- tions. Aliment Pharmacol Ther 28, 221–227 Alimentary Pharmacology & Therapeutics ª 2008 The Authors 221 Journal compilation ª 2008 Blackwell Publishing Ltd doi:10.1111/j.1365-2036.2008.03734.x