PMID- 26181108
OWN - NLM
STAT- MEDLINE
DCOM- 20160602
LR  - 20150902
IS  - 1473-5687 (Electronic)
IS  - 0954-691X (Linking)
VI  - 27
IP  - 10
DP  - 2015 Oct
TI  - IgE antibodies and skin tests in immediate hypersensitivity reactions to 
      infliximab in inflammatory bowel disease: impact on infliximab retreatment.
PG  - 1200-8
LID - 10.1097/MEG.0000000000000436 [doi]
AB  - BACKGROUND: Infliximab (IFX) is used for the treatment of inflammatory bowel 
      diseases (IBD). Immediate hypersensitivity reactions (HR) to IFX are frequently 
      reported. OBJECTIVES: We investigated immunoglobulin E (IgE)-mediated mechanisms 
      underlying immediate HR to IFX. We also evaluated the clinical utility of 
      allergological tests as well as the tolerability of IFX retreatment in these 
      patients. METHODS: This was a prospective single-center study including IBD 
      patients with previous immediate HR to IFX. Skin tests to IFX, including prick 
      tests and intradermal tests, and measurement of anti-IFX IgE antibodies were 
      performed at least 4 weeks after HR. In case of negative skin tests and absence 
      of IgE antibodies, readministration of IFX was performed with a twice-reduced 
      infusion rate. In case of positive tests or recurrence of HR during 
      readministration of IFX, a 12-step desensitization or induction of tolerance 
      protocol was proposed. RESULTS: A total of 24 IBD patients were included (Crohn's 
      disease: n=20). Prick tests to IFX were all negative. Intradermal test was 
      positive in one patient. Anti-IFX IgE antibodies were not detected in 21 patients 
      and were detected in three patients (significant level in one patient and 
      intermediate level in two patients). No relationship was observed between 
      positive skin tests and the presence of anti-IFX IgE antibodies. Switch to 
      adalimumab was well tolerated in 10/11 patients. The readministration of IFX was 
      well tolerated in 4/11 patients. Desensitization to IFX was successful in three 
      out of four patients. CONCLUSION: The vast majority of immediate HR to IFX is not 
      IgE-mediated. Allergological tests are of poor clinical utility. Desensitization 
      or induction of tolerance protocol may allow continuation of IFX therapy in IBD 
      patients with a history of immediate HR.
FAU - Freling, Estelle
AU  - Freling E
AD  - aDepartment of Dermatology and Allergy bInserm U954, Department of 
      Hepato-Gastroenterology cInserm U954, Department of Pediatrics dInserm U-954, 
      NGERE - Nutrition, Genetics, and Environmental Risk Exposure, Faculty of 
      Medicine, University Hospital of Nancy, Lorraine University, Vandoeuvre les 
      Nancy, France.
FAU - Peyrin-Biroulet, Laurent
AU  - Peyrin-Biroulet L
FAU - Poreaux, Claire
AU  - Poreaux C
FAU - Morali, Alain
AU  - Morali A
FAU - Waton, Julie
AU  - Waton J
FAU - Schmutz, Jean-Luc
AU  - Schmutz JL
FAU - Gueant, Jean-Louis
AU  - Gueant JL
FAU - Barbaud, Annick
AU  - Barbaud A
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
RN  - 0 (Antibodies, Anti-Idiotypic)
RN  - 0 (Gastrointestinal Agents)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - B72HH48FLU (Infliximab)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antibodies, Anti-Idiotypic/*blood/immunology
MH  - Child
MH  - Dose-Response Relationship, Drug
MH  - Drug Tolerance/immunology
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Follow-Up Studies
MH  - Gastrointestinal Agents/administration & dosage/adverse effects
MH  - Humans
MH  - Hypersensitivity, Immediate/chemically induced/diagnosis/*immunology
MH  - Immunoglobulin E/*immunology
MH  - Inflammatory Bowel Diseases/*drug therapy/immunology
MH  - Infliximab/*administration & dosage/adverse effects
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Recurrence
MH  - Retreatment
MH  - Skin Tests
MH  - Young Adult
EDAT- 2015/07/17 06:00
MHDA- 2016/06/03 06:00
CRDT- 2015/07/17 06:00
PHST- 2015/07/17 06:00 [entrez]
PHST- 2015/07/17 06:00 [pubmed]
PHST- 2016/06/03 06:00 [medline]
AID - 10.1097/MEG.0000000000000436 [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2015 Oct;27(10):1200-8. doi: 
      10.1097/MEG.0000000000000436.