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Published on: October 14, 2025

Short- and long-term response to and weaning from infliximab therapy in pediatric ulcerative colitis

Gary Fanjiang1, George H Russell, Aubrey J Katz

  • 1Department of Pediatric Gastroenterology & Nutrition, Massachusetts General Hospital for Children, Boston 02114, USA. gfanjiang@partners.org

Journal of Pediatric Gastroenterology and Nutrition
|February 28, 2007
PubMed

Insights

Infliximab effectively treated pediatric ulcerative colitis (UC) in acutely ill patients, with some able to discontinue treatment. However, response was less favorable in chronically ill, steroid-dependent UC patients.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Inflammatory Bowel Disease

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting children.
  • Treatment options for pediatric UC include steroids and biologics like infliximab.
  • Evaluating infliximab's efficacy and long-term outcomes in pediatric UC is crucial.

Purpose of the Study:

  • To assess infliximab response in pediatric ulcerative colitis patients.
  • To evaluate long-term follow-up and success of infliximab weaning.
  • To compare outcomes in acutely versus chronically ill pediatric UC patients.

Main Methods:

  • Retrospective chart review of 27 pediatric UC patients treated with infliximab.
  • Classification of patients into acutely ill (n=16) and chronically ill (n=11) groups.
  • Assessment of disease activity using the Lichtiger Colitis Activity Index (LCAI) at baseline and 1-2 months.

Main Results:

  • Acutely ill patients showed significant LCAI reduction (11.4 to 0.3) vs. chronically ill (11.2 to 5.5).
  • Infliximab success rates were 75% in acutely ill and 27% in chronically ill patients.
  • 80% of successfully treated patients were weaned off infliximab, with a mean follow-up of 10 months.

Conclusions:

  • Infliximab demonstrates higher efficacy in acutely ill pediatric UC patients compared to chronically ill, steroid-dependent patients.
  • Successful infliximab treatment allows for potential weaning, maintaining remission in select pediatric UC cases.
  • Long-term follow-up indicates sustained remission is possible after infliximab discontinuation in some patients.
Abstract

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