Infliximab therapy in pediatric crohn's disease: A review

Kalyan Ray Parashette, Charan Raghavendra Makam, Carmelo Cuffari

Research output: Contribution to journalArticle

Abstract

Anti-tumor necrosis factor alpha (TNF-α) therapy has re-defined our treatment paradigms in managing patients with Crohn's disease (CD) and ulcerative colitis. Although the ACCENT studies showed proven efficacy in the induction and maintenance of disease remission in adult patients with moderate to severe CD, the pediatric experience was instrumental in bringing forth the notion of "top-down" therapy to improve overall clinical response while reducing the risk of complications resulting from long-standing active disease. Infliximab has proven efficacy in the induction and maintenance of disease remission in children and adolescents with CD. In an open-labeled study of 112 pediatric patients with moderate to severe CD, 58% achieved clinical remission on induction of infliximab (5 mg/kg) therapy. Among those patients who achieved disease remission, 56% maintained disease remission on maintenance (5 mg/kg every 8 weeks) therapy. Longitudinal follow-up studies have also shown that responsiveness to infliximab therapy also correlates well with reduced rates of hospitalization, and surgery for complication of long-standing active disease, including stricture and fistulae formation. Moreover, these children have also been shown to improve overall growth while maintaining an effective disease remission. The pediatric experience has been instructive in suggesting that the early introduction of anti-TNF-α therapy may perhaps alter the natural history of CD in children, an observation that has stimulated a great deal of interest among gastroenterologists who care for adult patients with CD.

Original languageEnglish (US)
Pages (from-to)57-63
Number of pages7
JournalClinical and Experimental Gastroenterology
Volume3
Issue number1
StatePublished - 2010

Fingerprint

Crohn Disease
Maintenance
Therapeutics
Pediatrics
Remission Induction
Infliximab
Pediatric Crohn's disease
Ulcerative Colitis
Fistula
Patient Care
Pathologic Constriction
Hospitalization
Tumor Necrosis Factor-alpha
Observation
Growth

Keywords

  • Crohn's disease
  • Infliximab
  • Pediatric

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Infliximab therapy in pediatric crohn's disease : A review. / Parashette, Kalyan Ray; Makam, Charan Raghavendra; Cuffari, Carmelo.

In: Clinical and Experimental Gastroenterology, Vol. 3, No. 1, 2010, p. 57-63.

Research output: Contribution to journalArticle

Parashette, Kalyan Ray ; Makam, Charan Raghavendra ; Cuffari, Carmelo. / Infliximab therapy in pediatric crohn's disease : A review. In: Clinical and Experimental Gastroenterology. 2010 ; Vol. 3, No. 1. pp. 57-63.
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