Efficacy and Tolerance of Infliximab in Children and Adolescents with Crohn’s Disease (original) (raw)

Response to infliximab is related to disease duration in paediatric Crohn's disease

Alimentary Pharmacology and Therapeutics, 2003

Background: Infliximab is an effective therapy in adult patients with refractory and fistulizing Crohn's disease. Experience in children is still limited. Aim: To evaluate the experience in 22 children and adolescents treated with infliximab with refractory and/ or fistulizing Crohn's disease, and to compare duration of response in children between early Crohn's disease and late Crohn's disease. Methods: The experience in 22 children and adolescents treated with a total of 73 infusions was evaluated retrospectively. Treatment indication was refractory Crohn's disease in 9/22 patients, fistulizing Crohn's disease in 7/22 patients and both these conditions in 6/22. All patients with refractory Crohn's disease had late Crohn's disease (> 1 year), whereas 6/13 patients with fistulas had early disease (< 1 year). Results: Mean Paediatric Crohn's Disease Activity Index (PCDAI) decreased from 41.2 to 16.2 at 4 weeks (P < 0.01), and to 15.4 at 18 weeks (P < 0.01). Mean PCDAI at 18 weeks in children with early Crohn's disease and late Crohn's disease was 5.5 and 18.1, respectively (P < 0.05). Complete closure of fistulas was obtained in 5/6 children with early Crohn's disease and in 2/7 children with late Crohn's disease. Immediate adverse reactions were observed in two children. Conclusions: Infliximab is a highly effective treatment in children and adolescents with both severe refractory or fistulizing Crohn's disease. Children with early Crohn's disease have a higher chance of prolonged response to infliximab than children with late Crohn's disease.

Infliximab dependency in pediatric Crohnʼs disease: Long-term follow-up of an unselected cohort

Inflammatory Bowel Diseases, 2008

Background: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD patients initially responding to infliximab therapy.

Long-term Outcomes of Infliximab Use for Pediatric Crohn Disease: A Canadian Multicenter Clinical Practice Experience

Journal of Pediatric Gastroenterology and Nutrition, 2018

 Dr. Carroll was involved in design of study, data acquisition, analysis, and interpretation, critical draft version for important intellectual content, and final approval of published version.  Dr. Wine was involved in design of study, data acquisition, analysis, and interpretation, critical draft version for important intellectual content, and final approval of published version.  Dr. Wrobel was involved in design of study, data acquisition, analysis, and interpretation, critical draft version for important intellectual content, and final approval of published version.  Ms. Van Woudenberg was involved in design of study, data acquisition, analysis, and interpretation, critical draft version for important intellectual content, and final approval of published version.  Dr. Huynh was involved in design of study, data acquisition, analysis, and

Infliximab dependency in pediatric Crohn's disease: Long-term follow-up of an unselected cohort

Inflammatory Bowel Diseases, 2008

Background: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD patients initially responding to infliximab therapy.Methods: All pediatric patients treated with infliximab by pediatric gastroenterologists in the Netherlands because of severe luminal or fistulizing CD with initial response to infliximab therapy were reviewed. Duration of therapy, clinical response and adverse events were recorded.Results: Sixty-six CD patients (37 boys) in 10 hospitals were initially responding to infliximab therapy. Mean age at the start of infliximab therapy was 14.5 years (range, 8.1-18.5 years). Mean follow-up since infliximab was started was 41.3 months (range 12-165). In total, 991 infusions were administered. Analysis demonstrates that 15.2% of patients had prolonged response, while 56.1% were infliximab dependent and 28.8% lost response. In total, 10 patients (15.2%) developed an infection during infliximab therapy and 8 (12.1%) had an immediate allergic reaction.Conclusions: Good clinical response to maintenance infliximab therapy was seen in 70% of patients. Infliximab maintenance therapy seems very effective and safe in pediatric CD. However, more than half of the patients in this cohort is dependent on repeated infliximab infusions. The number of infliximab infusions received when patients lost response to infliximab was diverse. There was no statistical difference regarding response to infliximab therapy when started early as compared to later in the course of Crohn's disease.(Inflamm Bowel Dis 2007)