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Predictors of response to infliximab in paediatric perianal Crohn's disease

C Dupont-Lucas1, A Dabadie, C Alberti

  • 1Département de Pédiatrie, Centre Hospitalier Universitaire de Caen, Caen, France; Université de Basse Normandie, Caen, France.

Alimentary Pharmacology & Therapeutics
|August 23, 2014
PubMed

Insights

Predictors of infliximab (IFX) response in pediatric perianal Crohn's disease (CD) include fewer fistulas and a lower Harvey-Bradshaw index. Longer disease duration also improves outcomes for these patients.

Area of Science:

  • Pediatric gastroenterology
  • Immunology
  • Inflammatory bowel disease research

Background:

  • Perianal Crohn's disease (CD) affects pediatric patients, with a significant percentage (27-54%) showing no response to infliximab (IFX).
  • Identifying predictors of IFX response is crucial for optimizing treatment strategies in this population.

Purpose of the Study:

  • To determine factors predicting treatment response to infliximab (IFX) in pediatric patients diagnosed with perianal Crohn's disease (CD).

Main Methods:

  • A retrospective cohort study involved 101 pediatric patients with perianal CD treated with IFX from 2000-2011.
  • Response was assessed after induction and at one year, defining complete response by fistula closure and ulcer healing.
  • Logistic regression and Cox models analyzed baseline characteristics for their association with 1-year response and time to first relapse.

Main Results:

  • 88% responded to induction, and 75% were responders at one year (54% complete response).
  • Predictors for 1-year response included ≤1 fistula (OR: 3.76) and a baseline Harvey-Bradshaw index <5 (OR: 3.72).
  • Predictors for relapse among initial responders were CD duration <10 months (OR: 3.31) and >1 fistula (OR: 2.79).

Conclusions:

  • Pediatric perianal Crohn's disease patients with fewer fistulas and a lower baseline Harvey-Bradshaw index demonstrate better outcomes.
  • Longer duration of Crohn's disease prior to treatment is also associated with improved treatment response and reduced relapse rates.
Abstract

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