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Related Experiment Videos

Accelerated Step-Up Infliximab Use Is Associated with Sustained Primary Response in Pediatric Crohn's Disease.

J Ling1, D Buurman1, M Ravikumara2

  • 1Medical School, University of Western Australia, Crawley, WA, Australia.

Digestive Diseases and Sciences
|February 27, 2018
PubMed
Summary

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Early infliximab (IFX) treatment in pediatric Crohn's disease (CD) significantly improves sustained remission rates. Initiating IFX within three months of diagnosis is linked to better long-term outcomes in children with CD.

Area of Science:

  • Pediatric gastroenterology
  • Immunomodulatory therapies
  • Inflammatory bowel disease research

Background:

  • Crohn's disease (CD) management in children often involves complex treatment strategies.
  • The timing of infliximab (IFX) initiation may impact long-term remission in pediatric CD.
  • Understanding predictors of sustained response is crucial for optimizing therapy.

Purpose of the Study:

  • To evaluate the association between early versus late infliximab (IFX) initiation and sustained primary response (SPR) in pediatric Crohn's disease (CD).
  • To identify clinical predictors of SPR in children with CD receiving scheduled IFX therapy.
  • To assess outcomes in children with CD treated with IFX after a minimum of 2-year follow-up.

Main Methods:

  • Retrospective analysis of pediatric patients with luminal CD on scheduled IFX therapy.
Keywords:
Accelerated early use of InfliximabInfliximabLoss of responseSustained primary response

Related Experiment Videos

  • Inclusion criteria: successful induction therapy (PCDAI drop ≥15) and ≥2-year IFX follow-up.
  • Comparison of outcomes between early (≤3 months from diagnosis) and late (>3 months from diagnosis) IFX initiation.

    • Main Results:

    • Forty-three pediatric CD patients met inclusion criteria; 40% achieved sustained primary response (SPR) over a median 3.05-year follow-up.
    • Early IFX initiation (median 5.4 months from diagnosis) was significantly associated with SPR compared to later initiation (median 18.7 months).
    • Multivariable analysis confirmed early IFX use as the sole predictor of SPR.

    Conclusions:

    • Early step-up infliximab (IFX) therapy in children with Crohn's disease (CD) demonstrates a sustained primary response.
    • Initiating IFX within three months of diagnosis is a key factor for achieving long-term remission in pediatric CD patients.
    • This strategy offers a promising approach for managing pediatric CD.