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Infliximab efficacy in pediatric ulcerative colitis
Alexandra P Eidelwein1, Carmen Cuffari, Vivian Abadom
1Pediatric Gastroenterology and Nutrition, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Inflammatory Bowel Diseases
|March 1, 2005
Summary
Infliximab effectively treats pediatric ulcerative colitis, showing significant short-term improvement and long-term response in most children. Combined therapy with 6-mercaptopurine may enhance outcomes.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Inflammatory Bowel Disease Research
Background:
- Infliximab, a TNF-alpha inhibitor, is established for adult Crohn's disease.
- Pediatric ulcerative colitis treatment efficacy for infliximab requires further evaluation.
Purpose of the Study:
- To assess the short- and long-term effectiveness of infliximab in pediatric patients with ulcerative colitis.
- To evaluate adverse reactions associated with infliximab treatment in children.
Main Methods:
- Retrospective review of pediatric patients with ulcerative colitis treated with infliximab.
- Evaluation of short-term and long-term outcomes, including clinical response and colectomy rates.
- Analysis of corticosteroid dosage reduction and concurrent medication use.
Main Results:
- Nine of twelve pediatric patients achieved complete short-term response.
- Eight patients were long-term responders (median follow-up 10.4 months).
- Significant reduction in corticosteroid use and better response in patients on 6-mercaptopurine.
Conclusions:
- Infliximab is a viable treatment option for moderate to severe pediatric ulcerative colitis.
- Consider infliximab for children with acute, moderate to severe ulcerative colitis symptoms.
- Steroid-refractory disease and lack of 6-MP may predict poorer long-term outcomes.