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 18 November 2017

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News

Infliximab response and disease duration in pediatric Crohn's disease

Infliximab is an effective treatment for children and adolescents with severe refractory or fistulizing Crohn's disease, finds a team in the latest issue of Alimentary Pharmacology and Therapeutics.

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Infliximab has been shown to be an effective therapy in adult patients with Crohn's disease, however there is little data available on its efficacy in children.

In this study, a team of scientists from Italy evaluated infliximab treatment in children and adolescents with refractory or fistulizing Crohn's disease. They also compared the duration of response between early and late disease.

The team retrospectively assessed 22 children and adolescents who were treated with a total of 73 infliximab infusions.

Of the 22 patients included in this study, 41% had refractory Crohn's disease, 32% had fistulizing disease, and 27% had both.
The complete closure of fistulas occurred in 83% of children with early Crohn's disease.
Alimentary Pharmacology and Therapeutics

In addition, all patients with refractory disease had late Crohn's disease (greater than 1 year), while 46% of patients with fistulas had early disease (less than 1 year).

The researchers found that the mean Pediatric Crohn's Disease Activity Index (PCDAI) decreased from 41.2 to 16.2 4 weeks after treatment. This further decreased to 15.4 at 18 weeks.

However, they determined that the mean PCDAI at 18 weeks was 5.5 in children with early Crohn's disease, compared with 18.1 in children with late disease. Furthermore, the complete closure of fistulas was obtained in 83% of children with early Crohn's disease, compared to 29% of children with late Crohn's disease.

Dr Lionetti's team concluded, "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".

Aliment Pharmacol Ther 2003; 18(4): 425-31
27 August 2003

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