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Early Infliximab Yields Superior Long-Term Effects on Linear Growth in Pediatric Crohn's Disease Patients
Jaeyoung Choi1, Ben Kang2,3, Min-Ji Kim4
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Early combined immunosuppression with infliximab and azathioprine significantly improved linear growth in pediatric Crohn's disease patients. This approach is recommended for enhancing growth outcomes in children with CD.
Area of Science:
- Pediatric Gastroenterology
- Immunosuppressive Therapy
- Crohn's Disease Research
Background:
- Limited data exists on early infliximab efficacy in pediatric Crohn's disease (CD).
- Evaluating early combined immunosuppression's impact on linear growth is crucial for pediatric CD management.
Purpose of the Study:
- To assess the effect of early combined immunosuppression on linear growth in pediatric CD patients.
- To compare growth outcomes in pediatric CD patients receiving combination therapy.
Main Methods:
- Retrospective study of pediatric patients with moderate-to-severe CD.
- Inclusion criteria: at least 3 years of infliximab and azathioprine combination therapy, sustained corticosteroid-free remission.
- Comparison of growth indicator z-scores at diagnosis and annually for 3 years.
Main Results:
- Early combined immunosuppression group showed significantly increased linear growth at 3 years post-diagnosis (p=0.026).
- Significant linear growth improvement was noted in early-stage puberty subgroups (Tanner stages 1-2, p=0.016).
Conclusions:
- Early introduction of biologics, like infliximab, is recommended.
- This strategy can potentially improve linear growth in pediatric patients with Crohn's disease.
Background/Aims:
Information regarding the efficacy of early infliximab treatment in pediatric patients with Crohn's disease (CD) is limited. We aimed to evaluate the impact of early combined immunosuppression on linear growth in pediatric patients with CD by performing step-up comparisons.
Methods:
This retrospective study included pediatric patients with moderate-to-severe CD, who received a combination therapy with infliximab and azathioprine for at least 3 years and sustained corticosteroid-free remission without loss of response. The z-scores of the growth indicators obtained at the time of diagnosis and annually for 3 years thereafter were compared between the two groups.
Results:
The early combined immunosuppression group displayed significantly increased linear growth 3 years after diagnosis (p=0.026). A significant difference was also observed in the linear growth 3 years after diagnosis between subgroups of Tanner stages 1-2 (p=0.016).
Conclusions:
The early introduction of biologics should be considered to improve linear growth in pediatric patients with CD.