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Since 1 January 2003 we have changed our routine clinical practice and now give infliximab over 1 instead of 2 hours to those patients who have had at least three uneventful prior infusions (that is, did not experience infusion related side effects). To date, we have given 440 such infusions to 113 patients. Four infusions (0.9%) occurring in four different patients were associated with an adverse event: general infusion related symptoms rated as mild in two patients, tiredness rated as moderate after the infusion in one patient, and a sense of pressure over the eyes in one patient with prior open angle glaucoma. This last patient was subsequently examined by an ophthalmologist and ocular pressure was documented as normal. The pressure sensation resolved subsequently. The <1% incidence of infusion related adverse events compares favourably with the overall incidence of such events at our institution, which is about 5%; this is of course explained by our selection of patients with prior uneventful infusions.
We conclude that more rapid infliximab infusions over 1 hour, when given to patients who have tolerated at least three previous infliximab infusions without side effects, are tolerated well. Administering infliximab over 1 hour to such patients is a useful saving of time for both the patient and the healthcare provider.