Document Detail

Long-term outcome of treatment with infliximab in pediatric-onset Crohn's disease: A population-based study.
MedLine Citation:
PMID:  21287665     Owner:  NLM     Status:  Publisher    
BACKGROUND: We examined short- and long-term benefits and safety of infliximab (IFX) in a population-based cohort of Crohn's disease (CD) patients <17 years old at diagnosis. METHODS: The following parameters were assessed: short- and long-term efficacy of IFX, impact of drug efficacy, and mode of administration on rate of resection surgery, growth and nutritional catch-up, and adverse events (AEs). RESULTS: In all, 120 patients (69 female) required IFX with a median duration of 32 months (Q1 = 8-Q3 = 60). Median age at diagnosis was 14.5 years (12-16) and median interval between diagnosis and IFX initiation was 41 months (22-78). Median follow-up since CD diagnosis was 111 months (75-161). Fifty patients (42%) received episodic and 70 (58%) maintenance therapy. Sixty-five (54%) patients were in the "IFX efficacy" group: 38 (32%) still receiving IFX at the last visit and 27 (22%) stopping IFX while in remission. The "IFX failure" group included 55 (46%) patients: 17 (14%) who stopped IFX due to AEs and 38 (32%) nonresponders. The risk of surgery was reduced (P = 0.009) in the "IFX efficacy" group and lower (P = 0.03) in patients with scheduled versus episodic therapy. Patients in the "IFX efficacy" group had significant catch-up growth (P = 0.04), while those in the "IFX failure" group did not. Twenty-four patients presented AEs leading to cessation of IFX in 17 of them. CONCLUSIONS: In this population-based cohort of pediatric-onset CD, IFX treatment was effective in more than half of patients during a median follow-up of 32 months. Long-term IFX responders had a lower rate of surgery and improved catch-up in growth, especially when receiving scheduled IFX therapy. (Inflamm Bowel Dis 2011;).
Valérie Cromb; Julia Salleron; Guillaume Savoye; Jean-Louis Dupas; Gwénola Vernier-Massouille; Eric Lerebours; Antoine Cortot; Véronique Merle; Francis Vasseur; Dominique Turck; Corinne Gower-Rousseau; Marc Lémann; Jean-Frédéric Colombel; Alain Duhamel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-1
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  -     ISSN:  1536-4844     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Gastroenterology Unit, EPIMAD Registry, Lille University Hospital, Lille, France.
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