Alternative strategies for the use of infliximab in pediatric inflammatory bowel disease
- 48 Downloads
Infliximab is approved for the induction and 1-year maintenance of remission in pediatric Crohn’s disease unresponsive to conventional therapy. Despite significant experience with the use of this agent in children and adolescents who have inflammatory bowel disease, many questions about its optimal use remain. Recent safety concerns raised debate over the common practice of using infliximab in combination with conventional immunomodulatory agents. Additionally, although regularly scheduled administration maintains remission more effectively than episodic therapy, it is not known whether all patients who start infliximab must continue it for maintenance. Some patients may be able to use infliximab for induction and another agent for maintenance. Finally, the optimal placement of infliximab in the algorithm for the medical treatment of pediatric inflammatory bowel disease remains an open question.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 2.Baldassano R, Ferry G, Griffiths A, et al.: Transition of the patient with inflammatory bowel disease from pediatric to adult care: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2002, 34:245–248.PubMedCrossRefGoogle Scholar
- 24.Remicade (infliximab) for IV injection (package insert). Malvern, PA: Centocor; 2007.Google Scholar
- 28.Feldman T, Youssef NN, Irizarry R, Rosh JR: Infliximab as an induction agent versus ongoing maintenance therapy in mild-moderate pediatric Crohn’s disease [abstract]. Gastroenterology 2007, 2069:A444.Google Scholar
- 29.Chaudhary R, Butler M, Playford R, et al.: Combination immunomodulatory therapy with infliximab increases mononuclear cell apoptosis in-vitro compared to infliximab alone. Gastroenterology 2005:A149.Google Scholar
- 37.Kugathasan S, Ehlert R, Stephens MC, et al.: Immunomodulators are not required to maintain efficacy with infliximab in pediatric inflammatory bowel disease [abstract]. Gastroenterology 2007, 132:A443.Google Scholar
- 47.Romeo E, Viola F, De Angelis G, et al.: Infliximab as a first choice therapy in children with newly diagnosed Crohn’s disease (CD) promotes long-term sustained remission and alters the course of the disease. Gastroenterology 2006, 130:A142.Google Scholar