Infliximab Delays but Does Not Avoid the Need for Surgery in Treatment-Resistant Pediatric Crohn’ Disease
- N. A. AfzalAffiliated withDepartment of Paediatrics, Southampton University Hospital NHS Trust
- , A. OzzardAffiliated withCentre for Paediatric Gastroenterology
- , S. KeadyAffiliated withDepartment of Pharmacy, Royal Free Hospital
- , M. ThomsonAffiliated withDepartment of Paediatric Gastroenterology, Sheffield Children’s Hospital
- , S. MurchAffiliated withCentre for Paediatric Gastroenterology
- , R. HeuschkelAffiliated withCentre for Paediatric GastroenterologyCentre for Pediatric Gastroenterology, Royal Free Hospital Email author
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The aim of this study was to review the impact of infliximab therapy on children with treatment-resistant Crohn’s disease. Treatment resistance was defined as clinically active disease despite > 4 months of immunosuppressive therapy. The outcome variables were time to first remission, duration of remission and the need for surgery. 24 children received 90 infusions of infliximab (16 boys; median 10.3y, range 1.0–14.4y); all had three infusions as an induction course. 17 (70.8%) achieved clinical remission, with 14/17 (82.3%) relapsing within 4 months of the third infusion. 6/7 in the non-responding group and 8/17 of the responders required surgery with an insignificant difference in the median time to surgery (p = 0.49). Four remain dependent on regular infliximab. Infliximab is well-tolerated and highly effective in achieving clinical remission in children with refractory Crohn’s disease but may only delay and not avoid the need for surgery. Failure to achieve clinical remission by the 3rd infusion significantly increases the risk of surgery.
Key wordsinfliximab child Crohn’s disease inflammatory bowel disease treatment resistance surgery
- Infliximab Delays but Does Not Avoid the Need for Surgery in Treatment-Resistant Pediatric Crohn’ Disease
Digestive Diseases and Sciences
Volume 52, Issue 12 , pp 3329-3333
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- Springer US
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- Crohn’s disease
- inflammatory bowel disease
- treatment resistance
- Industry Sectors
- Author Affiliations
- 1. Department of Paediatrics, Southampton University Hospital NHS Trust, Southampton
- 2. Centre for Paediatric Gastroenterology, London, UK.
- 3. Department of Pharmacy, Royal Free Hospital, London, UK.
- 4. Department of Paediatric Gastroenterology, Sheffield Children’s Hospital, Sheffield, UK.
- 5. Centre for Pediatric Gastroenterology, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, UK