| Appropriate infliximab infusion dosage and monitoring: results of a panel meeting of rheumatologists, dermatologists and gastroenterologists. | |
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MedLine Citation:
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PMID: 21143496 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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WHAT THIS STUDY ADDS: This study is the first study which compared current international, national and local guidelines from the medical specialties involved in the treatment with infliximab on the following topics: indication, dosage, synergy and monitoring of vital signs. AIMS: Infliximab, an anti-TNF biologic agent, is currently indicated and reimbursed for rheumatoid arthritis, ankylosing spondylitis, Crohn's disease (both adult and paediatric), ulcerative colitis, psoriatic arthritis and plaque psoriasis. Development of national and international guidelines for rheumatology, gastroenterology and dermatology, was mostly based on clinical studies and expert opinion. The aim of this study was to compare available guidelines and local protocols for rheumatology, dermatology and gastroenterology, regarding dosage of infliximab, synergy of infliximab with concomitant medication and monitoring of vital signs during infliximab administration, for achieving optimal care. METHODS: Current international, national and local guidelines on the use of infliximab were reviewed and compared, differences and shortcomings were identified, and optimal treatment schedules discussed during a meeting (July 2008) of clinical experts and researchers from three departments of a Dutch university hospital. RESULTS: Recommended dosages of infliximab are not equal for different indications. Loss of response to infliximab is a common problem encountered within the three medical specialties, but indications for adjustments in treatment schedules are lacking in all of the guidelines. Monitoring of vital signs (blood pressure, pulse, temperature) during infusion with infliximab is common practice and recommended by some guidelines. Routine measurement of vital signs is not of any value in predicting or recognizing acute infusion reactions, in our experience, and this is confirmed by literature on inflammatory bowel disease. CONCLUSION: Different indications encompass different dosing schedules. National and internal guidelines do not provide advice regarding loss of response. Routine measurement of vital signs during infusion is not valuable in detecting acute infusion reactions and should only be performed in case of an acute infusion reaction. These topics need to be studied in future studies and covered in future guidelines. |
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Authors:
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Hilbert S de Vries; Martijn G H van Oijen; Rieke J B Driessen; Elke M G J de Jong; Marjonne C W Creemers; Wietske Kievit; Dirk J de Jong |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: British journal of clinical pharmacology Volume: 71 ISSN: 1365-2125 ISO Abbreviation: Br J Clin Pharmacol Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-14 Completed Date: 2011-02-24 Revised Date: 2012-01-02 |
Medline Journal Info:
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Nlm Unique ID: 7503323 Medline TA: Br J Clin Pharmacol Country: England |
Other Details:
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Languages: eng Pagination: 7-19 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. British Journal of Clinical Pharmacology © 2010 The British Pharmacological Society. |
Affiliation:
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Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anti-Inflammatory Agents / therapeutic use* Antibodies, Monoclonal / administration & dosage* Arthritis / drug therapy* Child Drug Monitoring Humans Inflammatory Bowel Diseases / drug therapy* International Cooperation Skin Diseases / drug therapy* Treatment Outcome Vital Signs / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/infliximab |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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