Early Infliximab Yields Superior Long-Term Effects on Linear Growth in Pediatric Crohn’s Disease Patients

@article{Choi2018EarlyIY,
  title={Early Infliximab Yields Superior Long-Term Effects on Linear Growth in Pediatric Crohn’s Disease Patients},
  author={Jaeyoung Choi and Ben Kang and Min-Ji Kim and Insuk Sohn and Hae Jeong Lee and Yon Ho Choe},
  journal={Gut and Liver},
  year={2018},
  volume={12},
  pages={255 - 262}
}
Background/Aims Information regarding the efficacy of early infliximab treatment in pediatric patients with Crohn’s disease (CD) is limited. We aimed to evaluate the impact of early combined immunosuppression on linear growth in pediatric patients with CD by performing step-up comparisons. Methods This retrospective study included pediatric patients with moderate-to-severe CD, who received a combination therapy with infliximab and azathioprine for at least 3 years and sustained corticosteroid… 

Figures and Tables from this paper

Early Biologic Treatment in Pediatric Crohn's Disease: Catching the Therapeutic Window of Opportunity in Early Disease by Treat-to-Target

  • B. KangY. Choe
  • Medicine
    Pediatric gastroenterology, hepatology & nutrition
  • 2018
The emergence of mucosal healing as a treatment goal that could modify the natural course of Crohn's disease and the accumulating evidence showing that biologics are most effective in achieving mucosal Healing, along with the success of early treatment regimens for rheumatoid arthritis, have led to an increasing number of pediatric gastroenterologists adopting an early biologic treatment strategy with or without an immunomodulator.

Infliximab Trough Levels Are Associated With Mucosal Healing During Maintenance Treatment With Infliximab in Paediatric Crohn’s Disease

Identification of the infliximab trough level that positively associates with mucosal healing in most paediatric patients with Crohn's disease may guide treatment decisions to optimise therapeutic response in the era of treat-to-target.

The Long-Term Effect of Early Anti-Tumor Necrosis Factor on Restoration of Growth in Pediatric Crohn’s Disease

The recent guidelines of the European Crohn’s and Colitis Organization and European Society for Pediatric Gastroenterology, Hepatology, and Nutrition state that infliximab may be considered as a primary induction regimen in selected children with high risks, which include marked growth retardation of >–2.5 height z-score.

Positioning Biologic Therapies in the Management of Pediatric Inflammatory Bowel Disease.

The key evidence for biologic agents currently used in the treatment of pediatric IBD is summarized and challenges and barriers unique to pediatric drug development are discussed.

Factors Associated with the Immunogenicity of Anti-Tumor Necrosis Factor Agents in Pediatric Patients with Inflammatory Bowel Disease

IFX TL was the only factor associated with ADA formation in pediatric IBD patients receiving IFX, and future studies based on serial and proactive therapeutic drug monitoring are required in the future.

Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts

Almost half of pediatric Crohn's disease patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts.

Precision medicine for pediatric inflammatory bowel disease: a perspective

It is speculated that model-based proactive dosing with point-of-care assay will soon emerge as the new standard for IBD treatment and “treat-to-target,” “top-down strategy,’ and ”TDM” may aid personalized therapy to achieve outstanding improvement in patients with pediatric IBD.

Pediatric inflammatory bowel disease: continuous lessons for adult inflammatory bowel disease.

Pediatric IBD research has been focusing on better phenotyping at diagnosis, and development of molecular signatures of future disease behavior by using relevant intestinal tissue rather than blood to develop risk stratified and treated based on individualized distinct biological and clinical information.

Updates in Healthcare Maintenance and Monitoring of Children with Inflammatory Bowel Disease in the Era of Biologic Therapies

The currently available therapies and general treatment strategies for the management of pediatric IBD, along with clinical considerations in the context of general pediatric care are reviewed.

Acute pancreatitis associated with indigo naturalis in pediatric severe Crohn’s disease

A case of recurrent events of pancreatitis that occurred briefly after starting medication with indigo naturalis in a child with severe Crohn’s disease is reported, the first case to report the association between pancreatitis and indigoNaturalis in the English literature.

References

SHOWING 1-10 OF 33 REFERENCES

Infliximab Maintains Durable Response and Facilitates Catch-up Growth in Luminal Pediatric Crohn's Disease

These data demonstrate sustained effectiveness of infliximab in children and adolescents with luminal CD, and clinical response is associated with enhanced linear growth, particularly when therapy is initiated early.

Infliximab heals intestinal inflammatory lesions and restores growth in children with Crohn's disease.

  • O. BorrelliC. Bascietto S. Cucchiara
  • Medicine
    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • 2004

Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children.

Pediatric patients responding to an induction regimen of infliximab were more likely to be in clinical response and remission at week 54 without dose adjustment when their maintenance therapy was given every 8 weeks rather than every 12 weeks.

Increased effectiveness of early therapy with anti-tumor necrosis factor-α vs an immunomodulator in children with Crohn's disease.

In children newly diagnosed with comparably severe CD, early monotherapy with anti-TNFα produced better overall clinical and growth outcomes at 1 year than earlymonotherapy with an immunomodulator.

The temporal evolution of antidrug antibodies in patients with inflammatory bowel disease treated with infliximab

Serial measurements showed that ATI development often preceded the onset of clinical flare, and survival free of clinical loss of response was enjoyed by 51% of patients, and serial measurements showed this incidence is reduced by concomitant immunomodulator even in scheduled-therapy patients.

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

Anti-TNF therapy is more likely to be associated with growth improvement when used at earlier stages of puberty with remission a key growth-promoting strategy in pediatric Crohn disease.

Safety and efficacy of maintenance infliximab therapy for moderate-to-severe Crohn’s disease in children: REACH open-label extension

Among children with moderately-to-severely active Crohn’s disease who received infliximab for 46 weeks in REACH and then for up to 3 additional years in the REACH OLE, inflIXimab was effective in maintaining clinical benefit and was generally well-tolerated.

Infliximab “Top-Down” Strategy is Superior to “Step-Up” in Maintaining Long-Term Remission in the Treatment of Pediatric Crohn Disease

“Top-down” strategy had a longer remission period compared with the “step-up’ strategy in pediatric Crohn disease during a study period of 3 years, based on relapse-free rate and remission period rate.

Long‐term outcome of treatment with infliximab in pediatric‐onset Crohn's disease: A population‐based study

In this population‐based cohort of pediatric‐onset CD, IFX treatment was effective in more than half of patients during a median follow‐up of 32 months, and long‐term IFX responders had a lower rate of surgery and improved catch‐up in growth, especially when receiving scheduled IFX therapy.