BACKGROUND: We examined short- and long-term benefits and safety of infliximab (IFX) in a population-based cohort of Crohn's disease (CD) patients <17 years old at diagnosis. METHODS: The following parameters were assessed: short- and long-term efficacy of IFX, impact of drug efficacy, and mode of administration on rate of resection surgery, growth and nutritional catch-up, and adverse events (AEs). RESULTS: In all, 120 patients (69 female) required IFX with a median duration of 32 months (Q1 = 8-Q3 = 60). Median age at diagnosis was 14.5 years (12-16) and median interval between diagnosis and IFX initiation was 41 months (22-78). Median follow-up since CD diagnosis was 111 months (75-161). Fifty patients (42%) received episodic and 70 (58%) maintenance therapy. Sixty-five (54%) patients were in the "IFX efficacy" group: 38 (32%) still receiving IFX at the last visit and 27 (22%) stopping IFX while in remission. The "IFX failure" group included 55 (46%) patients: 17 (14%) who stopped IFX due to AEs and 38 (32%) nonresponders. The risk of surgery was reduced (P = 0.009) in the "IFX efficacy" group and lower (P = 0.03) in patients with scheduled versus episodic therapy. Patients in the "IFX efficacy" group had significant catch-up growth (P = 0.04), while those in the "IFX failure" group did not. Twenty-four patients presented AEs leading to cessation of IFX in 17 of them. CONCLUSIONS: In this population-based cohort of pediatric-onset CD, IFX treatment was effective in more than half of patients during a median follow-up of 32 months. Long-term IFX responders had a lower rate of surgery and improved catch-up in growth, especially when receiving scheduled IFX therapy.
BACKGROUND: We examined short- and long-term benefits and safety of infliximab (IFX) in a population-based cohort of Crohn's disease (CD) patients <17 years old at diagnosis. METHODS: The following parameters were assessed: short- and long-term efficacy of IFX, impact of drug efficacy, and mode of administration on rate of resection surgery, growth and nutritional catch-up, and adverse events (AEs). RESULTS: In all, 120 patients (69 female) required IFX with a median duration of 32 months (Q1 = 8-Q3 = 60). Median age at diagnosis was 14.5 years (12-16) and median interval between diagnosis and IFX initiation was 41 months (22-78). Median follow-up since CD diagnosis was 111 months (75-161). Fifty patients (42%) received episodic and 70 (58%) maintenance therapy. Sixty-five (54%) patients were in the "IFX efficacy" group: 38 (32%) still receiving IFX at the last visit and 27 (22%) stopping IFX while in remission. The "IFX failure" group included 55 (46%) patients: 17 (14%) who stopped IFX due to AEs and 38 (32%) nonresponders. The risk of surgery was reduced (P = 0.009) in the "IFX efficacy" group and lower (P = 0.03) in patients with scheduled versus episodic therapy. Patients in the "IFX efficacy" group had significant catch-up growth (P = 0.04), while those in the "IFX failure" group did not. Twenty-four patients presented AEs leading to cessation of IFX in 17 of them. CONCLUSIONS: In this population-based cohort of pediatric-onset CD, IFX treatment was effective in more than half of patients during a median follow-up of 32 months. Long-term IFX responders had a lower rate of surgery and improved catch-up in growth, especially when receiving scheduled IFX therapy.
Authors: Laura E Bauman; Ye Xiong; Tomoyuki Mizuno; Philip Minar; Tsuyoshi Fukuda; Min Dong; Michael J Rosen; Alexander A Vinks Journal: Inflamm Bowel Dis Date: 2020-02-11 Impact factor: 5.325
Authors: Subra Kugathasan; Lee A Denson; Thomas D Walters; Mi-Ok Kim; Urko M Marigorta; Melanie Schirmer; Kajari Mondal; Chunyan Liu; Anne Griffiths; Joshua D Noe; Wallace V Crandall; Scott Snapper; Shervin Rabizadeh; Joel R Rosh; Jason M Shapiro; Stephen Guthery; David R Mack; Richard Kellermayer; Michael D Kappelman; Steven Steiner; Dedrick E Moulton; David Keljo; Stanley Cohen; Maria Oliva-Hemker; Melvin B Heyman; Anthony R Otley; Susan S Baker; Jonathan S Evans; Barbara S Kirschner; Ashish S Patel; David Ziring; Bruce C Trapnell; Francisco A Sylvester; Michael C Stephens; Robert N Baldassano; James F Markowitz; Judy Cho; Ramnik J Xavier; Curtis Huttenhower; Bruce J Aronow; Greg Gibson; Jeffrey S Hyams; Marla C Dubinsky Journal: Lancet Date: 2017-03-02 Impact factor: 79.321
Authors: Millie D Long; Susan Hutfless; Michael D Kappelman; Hamed Khalili; Gilaad G Kaplan; Charles N Bernstein; Jean Frederic Colombel; Corinne Gower-Rousseau; Lisa Herrinton; Fernando Velayos; Edward V Loftus; Geoffrey C Nguyen; Ashwin N Ananthakrishnan; Amnon Sonnenberg; Andrew Chan; Robert S Sandler; Ashish Atreja; Samir A Shah; Kenneth J Rothman; Neal S Leleiko; Renee Bright; Paolo Boffetta; Kelly D Myers; Bruce E Sands Journal: Inflamm Bowel Dis Date: 2014-02 Impact factor: 5.325