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Prescribing Patterns and Awareness of Adverse Effects of Infliximab: A Health Survey of Gastroenterologists

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Abstract

We sought to determine prescribing patterns and awareness of adverse drug reactions to infliximab among gastroenterologists. A questionnaire was developed and mailed to all gastroenterologists in Maryland and Washington, D.C. Ninety-six of 336 (28.6%) gastroenterologists responded; 86% of respondents use infliximab often or sometimes and 48% infuse infliximab on-site. Only 48% of respondents use immunomodulators prior to infusing infliximab. Thirty-three percent of respondents do not prescribe maintenance infliximab. Respondents reported that infusion reactions occur in 12.9% of infliximab infusions. Most respondents order a purified protein derivative prior to starting infliximab. Respondents underestimated the risk of serious infection, death, demyelinating diseases, and malignancy and overestimated the risk of congestive heart failure. We conclude that a substantial number of gastroenterologists underutilize immunomodulators and fail to prescribe maintenance infliximab. Further, respondents were unaware of the frequency of major adverse events associated with infliximab. Education regarding treatment algorithms in CD and infliximab-related side effects is needed.

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Acknowledgments

This study was supported by an unrestricted educational grant from Centocor, Inc. However, Centocor did not participate in the study design, data collection, analysis of data, or manuscript preparation. The University of Maryland Medical Center provided a list of gastroenterologists in the region and assisted in the mailing of the survey. Special thanks go to Carla Hackshaw for her assistance with the coordination of all three mailings of the survey.

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Authors and Affiliations

  1. Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA

    Meaghan Donovan

  2. Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Kevin Lunney & Olivia Carter-Pokras

  3. Department of Medicine, Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, and Veterans Affairs, Maryland Heath Care System, Baltimore, Maryland, USA

    Raymond K. Cross

  4. Division of Gastroenterology and Hepatology, University of Maryland Medical Center, 22 South Greene Street, N3W62, Baltimore, Maryland, 21201, USA

    Raymond K. Cross

Authors
  1. Meaghan Donovan
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  2. Kevin Lunney
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  3. Olivia Carter-Pokras
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  4. Raymond K. Cross
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Corresponding author

Correspondence to Raymond K. Cross.

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Donovan, M., Lunney, K., Carter-Pokras, O. et al. Prescribing Patterns and Awareness of Adverse Effects of Infliximab: A Health Survey of Gastroenterologists. Dig Dis Sci 52, 1798–1805 (2007). https://doi.org/10.1007/s10620-006-9269-z

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  • DOI: https://doi.org/10.1007/s10620-006-9269-z

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