The effects of infliximab, a tumor necrosis factor-alpha antibody, have been well established in adult patients with inflammatory and fistulizing Crohn's disease.
Dr Eidelwein and colleagues evaluated the short- and long-term efficacy of infliximab in children with ulcerative colitis.
The research team identified all pediatric patients with ulcerative colitis who received infliximab between July 2001 and November 2003 at the Johns Hopkins Children's Center.
The team evaluated short- and long-term outcomes and adverse reactions.
Infliximab was given by the researchers to 12 pediatric patients with ulcerative colitis for treatment of fulminant colitis (3 patients), acute exacerbation of colitis (3), steroid-dependent colitis (5), and steroid-refractory colitis (1).
|Patients receiving 6-mercaptopurine had a better response to infliximab|
|Inflammatory Bowel Diseases|
The investigators found that 9 patients had a complete short-term response, and 3 had partial improvement.
The researchers showed that the mean per patient dose of corticosteroid after the first infliximab infusion decreased from 45 mg/day at the first infusion to 22 mg/day at 4 weeks and 8 mg/day at 8 weeks.
The team classified 8 patients as long-term responders with a median follow-up time of 10 months.
Of the 4 long-term nonresponders, the research team reported that 3 underwent colectomy, and the fourth has ongoing chronic symptoms.
3 of 4 long-term nonresponders were steroid-refractory compared with 1 of 8 long-term responders.
The investigative team noted that patients receiving 6-mercaptopurine had a better response to infliximab.
Dr Eidelwein concluded, “Infliximab should be considered in the treatment of children with symptoms of acute moderate to severe ulcerative colitis.”