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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Infliximab is a chimeric monoclonal antibody that binds to and blocks tumor necrosis factor &#945; and is the most effective biologic agent approved for the treatment of moderate-to-severe psoriasis&#46; It is administered by intravenous infusion&#44; usually in day hospitals on an outpatient basis&#46; The main problem with the administration of infliximab is the possibility of infusion reactions&#44; which may be immediate or delayed&#59; these reactions are related to the immunogenicity of this monoclonal antibody&#44; leading to the production of anti-infliximab antibodies&#46; Infusion reactions to infliximab are not usually anaphylactic &#40;ie&#44; they are not mediated by immunoglobulin E&#41;&#44; and re-exposure of the patient using specific protocols to prevent and treat these reactions is therefore possible&#46; The extensive experience in the use of infliximab for the treatment of rheumatic conditions and chronic inflammatory bowel disease has made it possible to develop infusion reaction management protocols&#59; these can be applied to dermatologic patients&#44; who constitute a growing proportion of patients treated with intravenous biologic agents&#46; The aim of this review is to draw up a consensus protocol for the treatment of infusion reactions in dermatologic patients treated with infliximab&#46;</p>"
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Vol. 100. Issue 2.
Pages 103-112 (March 2009)
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Vol. 100. Issue 2.
Pages 103-112 (March 2009)
Consensus statement
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Reactions to Infliximab Infusions in Dermatologic Patients: Consensus Statement and Treatment Protocol
Reacciones a la Infusión de Infliximab en Pacientes Dermatológicos
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L. Puiga,
Corresponding author
Lpuig@santpau.cat

Correspondence: Servicio de Dermatología, Hospital de la Santa Creu i de Sant Pau, Avda. Sant Antoni Maria Claret 167. 08025 Barcelona, Spain.
, E. Sáezb, M.J. Lozanob, X. Bordasc, J.M. Carrascosa,d, F. Gallardoe, J. Luelmof, M. Sánchez-Regañag, M. Alsinah, V. García-Patosi, for the Spanish Academy of Dermatology and Venereology Psoriasis Working Group
a Servicio de Dermatología, Hospital de la Santa Creu i de Sant Pau, Barcelona, Spain
b Servicio de Hospital de Día Polivalente, Hospital de la Santa Creu i de Sant Pau, Barcelona, Spain
c Servicio de Dermatología, Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
d Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
e Servicio de Dermatología, Hospital del Mar, Barcelona, Spain
f Servicio de Dermatología, Hospital de Sabadell, Corporació Parc Taulí, Sabadell, Barcelona, Spain
g Servicio de Dermatología, Hospital Universitari Sagrat Cor, Barcelona, Spain
h Servicio de Dermatología, Hospital Clínic, Barcelona, Spain
i Servicio de Dermatología, Hospital Vall d’Hebron, Barcelona, Spain
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Abstract

Infliximab is a chimeric monoclonal antibody that binds to and blocks tumor necrosis factor α and is the most effective biologic agent approved for the treatment of moderate-to-severe psoriasis. It is administered by intravenous infusion, usually in day hospitals on an outpatient basis. The main problem with the administration of infliximab is the possibility of infusion reactions, which may be immediate or delayed; these reactions are related to the immunogenicity of this monoclonal antibody, leading to the production of anti-infliximab antibodies. Infusion reactions to infliximab are not usually anaphylactic (ie, they are not mediated by immunoglobulin E), and re-exposure of the patient using specific protocols to prevent and treat these reactions is therefore possible. The extensive experience in the use of infliximab for the treatment of rheumatic conditions and chronic inflammatory bowel disease has made it possible to develop infusion reaction management protocols; these can be applied to dermatologic patients, who constitute a growing proportion of patients treated with intravenous biologic agents. The aim of this review is to draw up a consensus protocol for the treatment of infusion reactions in dermatologic patients treated with infliximab.

Key words:
infliximab
psoriasis
infusion reactions
monoclonal antibody
immunogenicity
Resumen

Infliximab, un anticuerpo monoclonal quimérico que se une y bloquea al factor de necrosis tumoral alfa, constituye el agente biológico más eficaz aprobado para el tratamiento de la psoriasis moderada a grave y se administra mediante infusión intravenosa, generalmente en Hospitales de Día de forma ambulatoria. Las reacciones infusionales, que pueden ser agudas y retardadas, constituyen el principal problema en la administración rutinaria de este fármaco, y están relacionadas con la inmunogenicidad del anticuerpo monoclonal que da lugar a la producción de anticuerpos dirigidos contra el mismo. Las reacciones infusionales a infliximab son en la mayoría de los casos no anafilácticas (mediadas por inmunoglobulina E [IgE]), lo que no excluye el retratamiento de los pacientes empleando protocolos específicos de prevención y tratamiento de las mismas. Existe una amplia experiencia sobre el uso de este fármaco en pacientes con enfermedades reumatológicas y enfermedad inflamatoria idiopática intestinal, lo que ha permitido desarrollar protocolos de tratamiento de las reacciones a la infusión aplicables a los pacientes dermatológicos, que constituyen un grupo cada vez más numeroso de los que son tratados con agentes biológicos por vía intravenosa. El objeto de la presente revisión es desarrollar un protocolo de tratamiento consensuado de las reacciones a la infusión en pacientes dermatológicos tratados con infliximab.

Palabras clave:
infliximab
psoriasis
reacciones a la infusión
anticuerpo monoclonal
inmunogenicidad
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Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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