محمود عزيز محمد الكندي

Background: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively, and are indicated in the treatment of inflammatory bowel disease (IBD). Both are administered by intravenous infusion and may be associated with different types of infusion reactions. Aims: To compare the incidence of infusion reactions in adult patients with IBD receiving IFX and VDZ treatment and to identify when these infusion reactions happened. Methods: We performed a retrospective review of all IFX and VDZ infusions performed at Concord Repatriation General Hospital and Macquarie University Hospital, Sydney, from January 2012 through March 2017. Fisher exact test and receiver operating characteristics (ROC) curve analysis were used. Results: A total of 157 consecutive patients who received 1921 IFX infusions and 61 patients who received 509 VDZ infusions were evaluated. All patients received intravenous hydrocortisone before IFX and VDZ infusion. Most patients were on concurrent immunomodulators (azathioprine or methotrexate). The overall incidence of infusion reactions to IFX was 1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting 1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2% (23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of mild-to-moderate reaction happened in VDZ infusion, but no severe reactions were observed. Compared with VDZ, IFX was associated with more mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia, and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference for severe reaction (such as significant hypotension, and severe dyspnea) was not statistically significant. Based on ROC curve analysis (Figure 1), the optimal number of IFX infusions after which infusion reactions were less likely to happen was eight (P < 0.01) and that for VDZ was not statistically significant. Conclusion: IFX is associated with more mild-to-moderate infusion reactions compared withVDZ, suggesting that IFX is associated with more immunogenicity.

Background: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively, and are indicated in the treatment of inflammatory bowel disease (IBD). Both are administered by intravenous infusion and may be associated with different types of infusion reactions. Aims: To compare the incidence of infusion reactions in adult patients with IBD receiving IFX and VDZ treatment and to identify when these infusion reactions happened. Methods: We performed a retrospective review of all IFX and VDZ infusions performed at Concord Repatriation General Hospital and Macquarie University Hospital, Sydney, from January 2012 through March 2017. Fisher exact test and receiver operating characteristics (ROC) curve analysis were used. Results: A total of 157 consecutive patients who received 1921 IFX infusions and 61 patients who received 509 VDZ infusions were evaluated. All patients received intravenous hydrocortisone before IFX and VDZ infusion. Most patients were on concurrent immunomodulators (azathioprine or methotrexate). The overall incidence of infusion reactions to IFX was 1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting 1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2% (23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of mild-to-moderate reaction happened in VDZ infusion, but no severe reactions were observed. Compared with VDZ, IFX was associated with more mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia, and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference for severe reaction (such as significant hypotension, and severe dyspnea) was not statistically significant. Based on ROC curve analysis (Figure 1), the optimal number of IFX infusions after which infusion reactions were less likely to happen was eight (P < 0.01) and that for VDZ was not statistically significant. Conclusion: IFX is associated with more mild-to-moderate infusion reactions compared withVDZ, suggesting that IFX is associated with more immunogenicity.

Background: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively, and are indicated in the treatment of inflammatory bowel disease (IBD). Both are administered by intravenous infusion and may be associated with different types of infusion reactions. Aims: To compare the incidence of infusion reactions in adult patients with IBD receiving IFX and VDZ treatment and to identify when these infusion reactions happened. Methods: We performed a retrospective review of all IFX and VDZ infusions performed at Concord Repatriation General Hospital and Macquarie University Hospital, Sydney, from January 2012 through March 2017. Fisher exact test and receiver operating characteristics (ROC) curve analysis were used. Results: A total of 157 consecutive patients who received 1921 IFX infusions and 61 patients who received 509 VDZ infusions were evaluated. All patients received intravenous hydrocortisone before IFX and VDZ infusion. Most patients were on concurrent immunomodulators (azathioprine or methotrexate). The overall incidence of infusion reactions to IFX was 1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting 1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2% (23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of mild-to-moderate reaction happened in VDZ infusion, but no severe reactions were observed. Compared with VDZ, IFX was associated with more mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia, and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference for severe reaction (such as significant hypotension, and severe dyspnea) was not statistically significant. Based on ROC curve analysis (Figure 1), the optimal number of IFX infusions after which infusion reactions were less likely to happen was eight (P < 0.01) and that for VDZ was not statistically significant. Conclusion: IFX is associated with more mild-to-moderate infusion reactions compared withVDZ, suggesting that IFX is associated with more immunogenicity.

Background: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively, and are indicated in the treatment of inflammatory bowel disease (IBD). Both are administered by intravenous infusion and may be associated with different types of infusion reactions. Aims: To compare the incidence of infusion reactions in adult patients with IBD receiving IFX and VDZ treatment and to identify when these infusion reactions happened. Methods: We performed a retrospective review of all IFX and VDZ infusions performed at Concord Repatriation General Hospital and Macquarie University Hospital, Sydney, from January 2012 through March 2017. Fisher exact test and receiver operating characteristics (ROC) curve analysis were used. Results: A total of 157 consecutive patients who received 1921 IFX infusions and 61 patients who received 509 VDZ infusions were evaluated. All patients received intravenous hydrocortisone before IFX and VDZ infusion. Most patients were on concurrent immunomodulators (azathioprine or methotrexate). The overall incidence of infusion reactions to IFX was 1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting 1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2% (23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of mild-to-moderate reaction happened in VDZ infusion, but no severe reactions were observed. Compared with VDZ, IFX was associated with more mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia, and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference for severe reaction (such as significant hypotension, and severe dyspnea) was not statistically significant. Based on ROC curve analysis (Figure 1), the optimal number of IFX infusions after which infusion reactions were less likely to happen was eight (P < 0.01) and that for VDZ was not statistically significant. Conclusion: IFX is associated with more mild-to-moderate infusion reactions compared withVDZ, suggesting that IFX is associated with more immunogenicity.

Background: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively, and are indicated in the treatment of inflammatory bowel disease (IBD). Both are administered by intravenous infusion and may be associated with different types of infusion reactions. Aims: To compare the incidence of infusion reactions in adult patients with IBD receiving IFX and VDZ treatment and to identify when these infusion reactions happened. Methods: We performed a retrospective review of all IFX and VDZ infusions performed at Concord Repatriation General Hospital and Macquarie University Hospital, Sydney, from January 2012 through March 2017. Fisher exact test and receiver operating characteristics (ROC) curve analysis were used. Results: A total of 157 consecutive patients who received 1921 IFX infusions and 61 patients who received 509 VDZ infusions were evaluated. All patients received intravenous hydrocortisone before IFX and VDZ infusion. Most patients were on concurrent immunomodulators (azathioprine or methotrexate). The overall incidence of infusion reactions to IFX was 1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting 1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2% (23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of mild-to-moderate reaction happened in VDZ infusion, but no severe reactions were observed. Compared with VDZ, IFX was associated with more mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia, and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference for severe reaction (such as significant hypotension, and severe dyspnea) was not statistically significant. Based on ROC curve analysis (Figure 1), the optimal number of IFX infusions after which infusion reactions were less likely to happen was eight (P < 0.01) and that for VDZ was not statistically significant. Conclusion: IFX is associated with more mild-to-moderate infusion reactions compared withVDZ, suggesting that IFX is associated with more immunogenicity.

Abstact Aims: Procalcitonin (PCT) is a marker used as an indicator of severe bacterial infection, which causes febrile seizure (FS). In this study, the level of PCT in patients with FS during the first hour of attack was investigated. Furthermore, the correlation between PCT and serum Ca and Mg was determined. Methodology: Sixty children (26 male and 34 female) with hyperthermia-induced seizures participated in the study. Blood sampling was performed when seizure attack elapsed (within the first hour of the attack). Patients were classified according to sex, Ca level, C-reactive protein (CRP, positive >6 mg/L), and PCT level (high PCT>0.5ng/mL). Thirty healthy children were selected as the control group. Results: PCT level increased in patients compared with that of the control group. Patients with normal or hyperPCT showed no correlation between PCT level with the total and ionized Ca and Mg. The PCT level between the hypocalcaemic and normocalcaemic groups was not significantly different. The PCT level significantly increased (p<0.05) in the group with higher CRP compared with that of the normal CRP group. During the first hour of FS attack, PCT increased with the increase in CRP and no correlation was observed between PCT and the total and ionized serum Ca and Mg levels. Conclusion: PCT increased and was correlated with CRP in patients with FS during the first hour of attack. The results indicated that PCT elevation is due to the infection and has no evident effect on Ca metabolism in the patients. It can be concluded that the increase in PCT may be due to the FS as a leading cause rather than the bacterial infection.

Abstract Aims: Procalcitonin (PCT) is a marker used as an indicator of severe bacterial infection, which causes febrile seizure (FS). In this study, the level of PCT in patients with FS during the first hour of attack was investigated. Furthermore, the correlation between PCT and serum Ca and Mg was determined. Methodology: Sixty children (26 male and 34 female) with hyperthermia-induced seizures participated in the study. Blood sampling was performed when seizure attack elapsed (within the first hour of the attack). Patients were classified according to sex, Ca level, C-reactive protein (CRP, positive >6 mg/L), and PCT level (high PCT>0.5ng/mL). Thirty healthy children were Mg. The PCT level between the hypocalcaemic and normocalcaemic groups was not significantly different. The PCT level significantly increased (p<0.05) in the group with higher CRP compared with that of the normal CRP group. During the first hour of FS attack, PCT increased with the increase in CRP and no correlation was observed between PCT and the total and ionized serum Ca and Mg levels. Conclusion: PCT increased and was correlated with CRP in patients with FS during the first hour of attack. The results indicated that PCT elevation is due to the infection and has no evident effect on Ca metabolism in the patients. It can be concluded that the increase in PCT may be due to the FS as a leading cause rather than the bacterial infection. selected as the control group. Results: PCT level increased in patients compared with that of the control group. Patients with normal or hyperPCT showed no correlation between PCT level with the total and ionized Ca and