Dr James Markowitz and colleagues described 3-month and 1-year outcomes of children with Crohn's disease treated with corticosteroids within 30 days of diagnosis.
The research team had particular emphasis on the influence of infliximab on these outcomes.
The team determined whether there are clinical or laboratory characteristics associated with corticosteroid therapy outcomes.
Data from 109 children were drawn from a multicenter observational registry that was started in 2002.
|60% of patients had a complete acute response to corticosteroids|
|Clinical Gastroenterology & Hepatology|
The researchers recorded clinical characteristics and data on corticosteroid and other therapies prospectively.
Corticosteroid therapy outcomes at 3 months were defined as complete acute response, partial response, or corticosteroid resistance.
At 1 year, the team determined corticosteroid responsiveness, dependence, and surgical rates.
Infliximab's influence on short- and long-term outcomes also was investigated.
At 3 months, the team found that 60% of patients had a complete acute response to corticosteroids, 24% had a partial response, and 17% were corticosteroid resistant.
At 1 year, 61% were corticosteroid responsive, 31% were corticosteroid dependent, and 8% required surgery.
The researchers noted that irrespective of the duration of corticosteroid treatment, 16 of 24 of corticosteroid-dependent/resistant patients discontinued corticosteroids after starting infliximab.
The team found that no clinical or laboratory characteristics at diagnosis predicted short-term outcome.
Growth impairment at diagnosis increased risk for corticosteroid dependence or surgery at 1 year.
Dr Markowitz's team concludes, “At 3 months, 84% of children had a complete or partial response to corticosteroids.”
“However, despite concomitant immunomodulators, at 1 year 31% were corticosteroid dependent and 8% required surgery.”
“Infliximab improves outcomes of corticosteroid-dependent/resistant patients because the duration of corticosteroid use can be controlled by initiating treatment with infliximab.”