| Abstract | BACKGROUND: Infliximab (IFX), the chimeric anti TNFalpha antibody, an established treatment for Crohn's disease in adults and in children, is used less frequently in ulcerative colitis (UC). AIM OF THE STUDY: To report the clinical course of pediatric patients with active UC receiving IFX. PATIENTS AND METHODS: Charts of 22 patients were reviewed (13 male, 9 female): 4 with a severe UC attack refractory to systemic corticosteroids (CS); 18 with a protracted course, of which 16 CS-dependent and 2 CS-resistant. The baseline therapeutic program consisted of 3 consecutive intravenous infusions (0, 2, 6 weeks) of IFX (5 mg/kg), followed by a retreatment schedule (infusion every 8 weeks); azathioprine (AZA) was administered chronically in all. Clinical evaluation was done with the Lichtiger Colitis Activity Index (LCAI). Follow-up was performed until week 54. LCAI >/= 9 was considered treatment failure; a LCAI </= 2 was consistent with remission. RESULTS: All 22 patients began the study with a LCAI > 9: 12 had a full response and were on remission at week 54 and did not receive CS (8 on IFX re-treatment and AZA, 4 on AZA alone); 6 had a partial response; 4 were non responders. Colectomy was performed in 7 patients, beyond the period of the acute attack in all but one. CONCLUSIONS: In children with severe ulcerative colitis IFX is a valuable treatment for inducing remission, avoiding emergency colectomy; retreatment may be offered to maintain remission. |
| Authors | S Cucchiara, E Romeo, F Viola, M Cottone, M Fontana, G Lombardi, V Rutigliano, G L de'Angelis, T Federici
(Affiliation: Division Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University of Rome "La Sapienza", Rome, Italy. salvatore.cucchiara at uniroma1.it)
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| Journal | Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
(Dig Liver Dis)
Vol. 40 Suppl 2
Pg. S260-4
(Jul 2008)
ISSN: 1590-8658 Netherlands |
| PMID | 18598998
(Publication Type: Journal Article, Multicenter Study)
|
| Chemical References |
- Antibodies, Monoclonal
- Immunosuppressive Agents
- infliximab
- Azathioprine
|
| Topics |
- Adolescent
- Antibodies, Monoclonal
(therapeutic use)
- Azathioprine
(therapeutic use)
- Child
- Colitis, Ulcerative
(drug therapy)
- Drug Therapy, Combination
- Female
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Italy
- Male
- Remission Induction
- Retrospective Studies
- Salvage Therapy
|
