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Intravenous hydrocortisone premedication reduces antibodies to infliximab in Crohn's disease: A randomized controlled trial

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dc.contributor.authorFarrell R.J.-
dc.contributor.authorAlsahli M.-
dc.contributor.authorJeen Y.-T.-
dc.contributor.authorFalchuk K.R.-
dc.contributor.authorPeppercorn M.A.-
dc.contributor.authorMichetti P.-
dc.date.available2020-11-03T19:46:40Z-
dc.date.issued2003-
dc.identifier.issn0016-5085-
dc.identifier.issn1528-0012-
dc.identifier.urihttps://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/21572-
dc.description.abstractBackground & Aims: We assessed the relationship between antibodies to infliximab (ATI) and the loss of response postinfliximab, infusion reactions and, in a randomized trial, investigated whether intravenous hydrocortisone premedication can reduce ATI. Methods: Initially, we prospectively evaluated clinical response, adverse events, and ATI levels in 53 consecutive patients with Crohn's disease who received 199 infliximab (5 mg/kg) infusions. Subsequently, 80 patients with Crohn's disease were randomized to intravenous hydrocortisone 200 mg or placebo immediately before their first and subsequent infliximab infusions. The primary endpoint was reduction in median ATI levels at week 16. Analysis was by intention to treat. Results: Nineteen of our initial 53 patients (36%) developed ATI, including all 7 patients with serious infusion reactions (median ATI level, 19.6 μg/mL). Eleven of 15 patients (73%) who lost their initial response were ATI positive compared with none of 21 continuous responders, (8.9 vs. 0.7 μg/mL, P < 0.0001). Administering a second infusion within 8 weeks of the first (OR, 0.13; 95% CI, 0.03-0.5; P = 0.0007) or concurrent immunosuppressants (OR, 0.19; 95% CI, 0.04-1.03; P = 0.007) significantly reduced ATI formation. In the placebo-controlled trial, ATI levels were lower at week 16 among hydrocortisone-treated patients (1.6 vs. 3.4 μg/mL, P = 0.02), and 26% of hydrocortisone-treated patients developed ATI compared with 42% of placebo-treated patients, P = 0.06. Conclusions: Loss of initial response and infusion reactions post-infliximab is strongly related to ATI formation and level. Administering a second infusion within 8 weeks of the first and concurrent immunosuppressant therapy significantly reduce ATI formation. Intravenous hydrocortisone premedication significantly reduces ATI levels but does not eliminate ATI formation or infusion reactions.-
dc.format.extent8-
dc.language영어-
dc.language.isoENG-
dc.publisherW.B. Saunders-
dc.titleIntravenous hydrocortisone premedication reduces antibodies to infliximab in Crohn's disease: A randomized controlled trial-
dc.typeArticle-
dc.publisher.location미국-
dc.identifier.doi10.1053/gast.2003.50145-
dc.identifier.scopusid2-s2.0-0037379792-
dc.identifier.bibliographicCitationGastroenterology, v.124, no.4, pp 917 - 924-
dc.citation.titleGastroenterology-
dc.citation.volume124-
dc.citation.number4-
dc.citation.startPage917-
dc.citation.endPage924-
dc.type.docTypeArticle-
dc.description.isOpenAccessN-
dc.description.journalRegisteredClassscopus-
dc.subject.keywordPlusdrug antibody-
dc.subject.keywordPlushydrocortisone-
dc.subject.keywordPlusinfliximab-
dc.subject.keywordPlusinfliximab antibody-
dc.subject.keywordPlusunclassified drug-
dc.subject.keywordPlusadult-
dc.subject.keywordPlusaged-
dc.subject.keywordPlusantibody blood level-
dc.subject.keywordPlusantibody production-
dc.subject.keywordPlusantigen antibody reaction-
dc.subject.keywordPlusarticle-
dc.subject.keywordPlusbolus injection-
dc.subject.keywordPlusclinical trial-
dc.subject.keywordPluscontrolled clinical trial-
dc.subject.keywordPluscontrolled study-
dc.subject.keywordPlusCrohn disease-
dc.subject.keywordPlusdisease activity-
dc.subject.keywordPlusdouble blind procedure-
dc.subject.keywordPlusdrug clearance-
dc.subject.keywordPlusdrug efficacy-
dc.subject.keywordPlusdrug infusion-
dc.subject.keywordPlusdrug safety-
dc.subject.keywordPlusenzyme linked immunosorbent assay-
dc.subject.keywordPlusfemale-
dc.subject.keywordPlushuman-
dc.subject.keywordPlusimmunogenicity-
dc.subject.keywordPlusimmunosuppressive treatment-
dc.subject.keywordPlusmajor clinical study-
dc.subject.keywordPlusmale-
dc.subject.keywordPluspremedication-
dc.subject.keywordPluspriority journal-
dc.subject.keywordPlusprospective study-
dc.subject.keywordPlusrandomized controlled trial-
dc.subject.keywordPlusside effect-
dc.subject.keywordAuthorpremedication-
dc.subject.keywordAuthorrandomized controlled trial-
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Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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