Infliximab Therapy in 30 Patients With Refractory Pediatric Crohn Disease With and Without Fistulas in The Netherlands

Abstract

Infliximab was an effective therapy in 53% of patients with refractory pediatric Crohn disease, with or without fistulas. Approximately half of the patients become unresponsive to infliximab therapy. Randomized controlled studies are mandatory to assess long-term efficacy and safety to define the optimal therapeutic strategy of infliximab therapy in children with Crohn disease.

Disease Status and Pubertal Stage Predict Improved Growth in Antitumor Necrosis Factor Therapy for Pediatric Inflammatory Bowel Disease

“…In our Scottish population-based cohort of children with all subtypes of PIBD treated with either IFX or ADA, anti-TNF therapy was associated with improved linear growth as has been demonstrated in other population based cohorts for IFX 31,32 ; however, to our knowledge this is the first population-based ADA study. At induction of IFX, 18% of children had a Ht SDS <-2, improving to 15% then 7% at 1 year and 2 years respectively after treatment.…”

“…<1 at initiation of IFX, 3 subsequently resumed normal growth velocity who remained on IFX post induction 32 . However, Wewer showed that in 10 CD patients who had IFX in part due to growth failure had no improvement was noted in height velocity when compared before and after treatment (no pubertal data or ht SDS were provided for this cohort) 18 .…”

Course and Treatment of Perianal Disease in Children Newly Diagnosed with Crohnʼs Disease

“…Infliximab is contraindicated in the presence of abscesses but has been shown to maintain fistula closure in a double-blinded study in adults and in limited pediatric data. 14,15 Infliximab was more likely to be used and used earlier in fistulizing patients than in nonfistulizing patients. Resolving patients did not differ from chronic patients in use of this medication.…”

Induction and Maintenance Infliximab Therapy for the Treatment of Crohn’s Disease with Perianal Fistulas in Children: Retrospective, Multicenter Study

“…In 30.43% of the children reoccurrence of fistula was observed. Other authors also describe good results of the treatment with infliximab of fistulas in children [38,39]. De Ridder et al [39] obtained a long clinical response in 56% of the patients.…”

“…Other authors also describe good results of the treatment with infliximab of fistulas in children [38,39]. De Ridder et al [39] obtained a long clinical response in 56% of the patients. Retrospective review of literature demonstrated that in 70% of the patients treated with infliximab fistula was closed within three months.…”