Infliximab efficacy in pediatric ulcerative colitis

Alexandra P. Eidelwein, Carmen Cuffari, Vivian Abadom, Maria Oliva-Hemker

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The effects of infliximab, a tumor necrosis factoralpha (TNF-α) antibody, have been well established in adult patients with inflammatory and fistulizing Crohn's disease. This study evaluates short- and long-term efficacy of infliximab in children with ulcerative colitis. Methods: All pediatric patients with ulcerative colitis who received infliximab between July 2001 and November 2003 at the Johns Hopkins Children's Center were identified. Short- and long-term outcomes and adverse reactions were evaluated. Results: Twelve pediatric patients with ulcerative colitis received infliximab for treatment of fulminant colitis (3 patients), acute exacerbation of colitis (3), steroid-dependent colitis (5), and steroidrefractory colitis (1). Nine patients had a complete short-term response, and 3 had partial improvement. The mean per patient dose of corticosteroid after the first infliximab infusion decreased from 45 mg/day at the first infusion to 22.2 mg/day at 4 weeks (P = 0.02) and 7.8 mg/day at 8 weeks (P = 0.008). Eight patients were classified as long-term responders with a median follow-up time of 10.4 months. Of the 4 long-term nonresponders, 3 underwent colectomy, and the fourth has ongoing chronic symptoms. Three of 4 long-term nonresponders were steroid-refractory compared with 1 of 8 longterm responders. Patients receiving 6-mercaptopurine had a better response to infliximab. Conclusion: Infliximab should be considered in the treatment of children with symptoms of acute moderate to severe ulcerative colitis.

Original languageEnglish (US)
Pages (from-to)213-218
Number of pages6
JournalInflammatory bowel diseases
Volume11
Issue number3
DOIs
StatePublished - Mar 1 2005

Keywords

  • Child
  • Drug therapy
  • Inflammatory bowel disease
  • Infliximab
  • Pediatric
  • Ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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