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Outcome following infliximab therapy in children with ulcerative colitis

Jeffrey S Hyams1, Trudy Lerer, Anne Griffiths

  • 1Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA. jhyams@ccmckids.org

The American Journal of Gastroenterology
|January 28, 2010
PubMed

Insights

Infliximab treatment for pediatric ulcerative colitis (UC) showed promising outcomes, with a significant portion of children achieving corticosteroid-free disease and avoiding colectomy within two years. This study highlights infliximab

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Inflammatory Bowel Disease Research

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting children.
  • Infliximab is an established treatment for moderate to severe UC in adults.
  • Limited data exists on infliximab's efficacy and safety in pediatric UC populations.

Purpose of the Study:

  • To evaluate the clinical outcomes of infliximab treatment in pediatric patients diagnosed with ulcerative colitis.
  • To assess the rates of corticosteroid-free disease and colectomy avoidance in this cohort.
  • To analyze treatment patterns and concomitant medication use in conjunction with infliximab therapy.

Main Methods:

  • A multicenter cohort study involving 332 newly diagnosed pediatric UC patients from the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry.
  • Prospective data collection on disease activity, medication use, and treatment outcomes at diagnosis and follow-up intervals.
  • Analysis of infliximab treatment outcomes, including corticosteroid-free disease and colectomy-free survival, using Kaplan-Meier methods.

Main Results:

  • Of 332 patients, 52 (16%) received infliximab, with 87% having pancolitis and a mean age of 13.3 years at initiation.
  • At 12 and 24 months, 38% and 21% of patients, respectively, achieved corticosteroid-free inactive disease.
  • Kaplan-Meier analysis indicated a 75% likelihood of remaining colectomy-free at 6 months, decreasing to 61% at 2 years.

Conclusions:

  • Infliximab treatment in pediatric ulcerative colitis patients can lead to sustained corticosteroid-free inactive disease.
  • A majority of pediatric UC patients treated with infliximab successfully avoided colectomy within the first two years.
  • These findings support the use of infliximab as an effective therapeutic option for moderate to severe pediatric UC.
Abstract

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