Infliximab for the treatment of pediatric ulcerative colitis

Abstract

Ulcerative colitis is a chronic, idiopathic, inflammatory disease of the colon and rectum that may be associated with growth failure, nutritional derangements and psychosocial ramifications in affected children. Multiple medical options are available to achieve disease remission; however, some of these medications can have unwanted side effects, especially in younger patients. With increased understanding of the etiology of the disease, newer therapeutic alternatives have arisen in the form of biologic therapies, namely monoclonal antibodies targeted to a specific protein or receptor. Specifically, infliximab, an anti-TNF-α agent, has been shown to be safe and effective for the treatment of moderate-to-severe pediatric ulcerative colitis.

Quantitation of infliximab using clonotypic peptides and selective reaction monitoring by LC–MS/MS

“…For Crohn's disease, a trough level of 3 μg/mL discriminated inflammatory activity as reflected by CRP serum levels (AUC of 68%) [22]. For ulcerative colitis, the highest proportion of patients in clinical remission was observed in patients with serum levels of infliximab between 2.4 and 6.8 μg/mL at week 30 [23,24]. Patients on scheduled maintenance infliximab therapy for Crohn's disease with detectable trough levels had a higher rate of clinical remission and higher rate of endoscopic improvement [25].…”

Pädiatrische Ernährungsmedizin

“…Bei Colitis ulcerosa ist die medikamentöse Therapie unverzichtbar, wobei inzwischen daneben auch monoklonale Antikörper erfolgreich angewandt werden [43]. Die antientzündliche Therapie mit Aminosalizylsäure muss von Folsäuregaben begleitet werden.…”