Managing paediatric acute severe ulcerative colitis according to the 2011 ECCO-ESPGHAN guidelines: Efficacy of infliximab as a rescue therapy

Change of treatment modalities over the last 10 years in pediatric patients with inflammatory bowel disease in Switzerland

“…With our study, we could not demonstrate a reduction of surgery within the first 5 years after diagnosis. These results are limited by the observational design of our study and its relatively small number of patients with complications but correlate with results from Italy in pediatric UC [28]. In fact, although 80% of steroid-refractory pediatric patients with acute severe UC received and responded initialy to infliximab, still up to 50% required elective colectomy during follow-up.…”

Management of Paediatric Ulcerative Colitis, Part 2

“…In two paediatric inception cohorts, the occurrence of ASC was associated with an increased risk of colectomy (7,8). The advent of calcineurin inhibitors and infliximab has reduced the short term colectomy rate from 40-70% (9,(11)(12)(13) to approximately 10-20% in children (10,14,15) and the 1-year colectomy rate from ~60% (9,16) to 18-22% (10,14,16).…”

“…Among those who fail IVCS treatment, roughly 50-60% of responders to salvage medical therapy will require colectomy within 1-2 years (10,14). To add to the complexity, enteric infections and adverse events to medications (primarily mesalamine and thiopurines intolerance) can mimic ASC.…”

Leveraging Big Data in Pediatric Development Programs: Proceedings From the 2016 American College of Clinical Pharmacology Annual Meeting Symposium

“…Clinical decision support systems (dashboards) may provide useful insight into the difficulties of determining appropriate treatment regimens in pediatric patients . Such Bayesian systems, which incorporate exposure and response models (often from adult data), can be used to individualize dosing strategies and identify and improve poor response before traditional assessments .…”