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Infliximab (IFX) is a widely used biologic agent in the management of paediatric inflammatory bowel disease (IBD). 1 2 Standard infusion regimens typically require two to three hours per dose.3 Evidence showed that accelerated IFX infusions administered over one hour are safe in adults with IBD and associated with an improved patient experience and more efficient use of healthcare resources.4 5 Despite these advantages, supporting data in the paediatric population remains limited.6–10 In the United Kingdom (UK), no studies have yet examined this approach.Given the growing use of IFX in IBD, this study aimed to evaluate the safety of accelerated IFX infusions in children with IBD by analysing the frequency and nature of both acute and delayed infusion reactions (IR). The primary outcomes were to determine the incidence and type of IR during the maintenance phase, while the secondary aim was to generate local evidence to inform the safe and effective implementation of rapid IFX infusions in paediatric practice.Following ethical approval from the local Research Governance and Ethics Committee, a retrospective cohort study was conducted at a tertiary paediatric centre in the South of England. In this hospital, patients who safely completed the induction phase at a standard rate were transitioned to the accelerated infusion protocol. All paediatric patients aged 2 to 18 years treated with IFX therapy, between August 2014 and August 2024, were considered eligible for this study. Data were extracted from medical records, including demographic characteristics, IBD subtype, number of accelerated infusions, use of pre-medication, concomitant immunomodulator therapy, and any documented IR. Descriptive and inferential statistical analyses were performed using IBM SPSS Statistics version 29, with statistical significance defined as p < 0.05.Initially, 65 children were identified; four were excluded due to incomplete medical records. All 61 included patients progressed to receive accelerated IFX infusions after completion of the induction phase. The majority of patients (n=48) had Crohn’s disease, 12 had ulcerative colitis, and 3 had IBD-unclassified. A total of 1,180 IFX infusions were administered at both the induction and maintenance phases. Of these, 977 were given at the accelerated rate.No IR were reported during both the induction and maintenance phases. None of the patients required pre-medication, and the majority (n = 58, 95%) were on concomitant immunomodulator therapy, most commonly azathioprine. The main findings are summarised in table 1.Although limited by its retrospective, single-centre design, this study provides the first UK-based evidence supporting the safety of accelerated IFX infusions in children with IBD. The results align with existing international data and suggest that implementing shortened infusion protocols may improve patient experience and optimise service efficiency (6-10). Larger multicentre studies are recommended to confirm these findings and to evaluate potential differences in IR rates across demographic, clinical, and treatment-related subgroups.This table presents the key results of the service evaluation assessing the safety of one-hour IFX infusions in children with IBD.References Ng SC, Shi HY, Hamidi N. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet Gastroenterol Hepatol. 2017;390(10114):2769–78.Kuenzig ME, Fung SG, Marderfeld L. Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review. Gastroenterology. 2022;162(4):1147–59.European Medicines Agency. Remicade: EPAR – Product information Internet].Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/remicadeNeef HC, Riebschleger MP, Adler J. Meta-analysis: rapid infliximab infusions are safe. Aliment Pharmacol Ther. 2013;38(4):365–76.Clare DF, Alexander FC, Mike S. Accelerated infliximab infusions are safe and well tolerated in patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2009;21(1):71–5.Jagt JZ, Galestin SE, Claesen J. Safety of accelerated infliximab infusions in children with inflammatory bowel disease: a retrospective cohort study. J Pediatr Gastroenterol Nutr. 2023;77(3):373–80.El-Matary W, Dykes DMH, Bauman L. Rapid infliximab infusion in children with inflammatory bowel disease: a multicenter North American experience. Inflamm Bowel Dis. 2017;23(12):2104–8.Van Wassenaer EA, van Oosterhout JPM, Daams JG. Safety of rapid infliximab infusions in children: a systematic review. J Pediatr Gastroenterol Nutr. 2020 Sep;71(3):361–365.Lev-Tzion R, Assa A, Yerushalmi B. Rapid infliximab infusion in children: a multicenter retrospective cohort study. J Pediatr Gastroenterol Nutr. 2017;65(5):e101-3.Hutsell SQ, Wu M, Park KT. Frequency of severe infusion reactions associated with outpatient infusion of infliximab without premedications. J Pediatr Gastroenterol Nutr. 2017;65(4):430–1.Abstract OC107 Table 1Main findings from the service evaluation of accelerated IFX infusions in paediatric IBD