Accelerated Step-Up Infliximab Use Is Associated with Sustained Primary Response in Pediatric Crohn's Disease

Digestive Diseases and Sciences
J LingZ Grover

Abstract

Earlier introduction of infliximab (IFX) in Crohn's disease (CD) may be associated with a sustained remission. Children on scheduled IFX therapy for predominant luminal CD after successful induction (drop in PCDAI by ≥ 15) and a minimum of 2-year IFX follow-up were included. We compared outcomes of children treated with early (within 3 months from diagnosis) versus later IFX (after failing conventional therapy ≥ 3 months) and identify clinical predictors of sustained primary response (SPR) in our cohort. SPR was defined as CS-free clinical remission without requiring IFX dose escalation and/or surgical excision and/or switch to second anti-TNFs due to LOR or allergic reaction. Sixty-four children received IFX therapy for CD during the study period. Forty-three children on scheduled IFX therapy for luminal CD met the inclusion criteria. During the median follow-up of 3.05 years (IQR 2.6-3.5 years), SPR was observed in 17/43 (40%). SPR was associated with shorter time from diagnosis to the initiation of IFX (5.4 vs. 18.7 months, p = 0.006). Binary logistic regression using multiple variables also confirmed that only early use of IFX is associated with SPR. Early step-up use of IFX in children with CD with inadequate clinical resp...Continue Reading

References

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Apr 16, 2010·The New England Journal of Medicine·Jean Frédéric ColombelUNKNOWN SONIC Study Group
Jun 10, 2014·Journal of Crohn's & Colitis·F M RuemmeleUNKNOWN European Society of Pediatric Gastroenterology, Hepatology and Nutrition

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Citations

Jan 12, 2019·Journal of Pediatric Gastroenterology and Nutrition·Karen van HoeveSéverine Vermeire
Aug 17, 2020·Paediatric Drugs·Karen van Hoeve, Séverine Vermeire

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