12‐Month Follow‐up After Successful Infliximab Therapy in Pediatric Crohn Disease

Abstract

These data indicate that IFX is efficacious in controlling severe pediatric CD; however, to induce and maintain clinical remission, repeated IFX infusions are required, with a need for dose adjustment in a substantial number of patients.

Systematic Review of Effects of Withdrawal of Immunomodulators or Biologic Agents From Patients With Inflammatory Bowel Disease

“…With the exception of the study by Sorrentino et al, 35 in which endoscopic remission was reported (100% remission at 80 weeks), most studies only provided rates of clinical remission/ response after re-treatment; in many cases, the information was restricted to the response rates, with no further details. 42,43,50,51,54,58,59,62 The studies by Molnar et al 43 and Monterubbianesi et al 51 reported the lowest response rates (54.7% and 63.3%, respectively) and the highest infusion reaction rates (6% and 10%, respectively). Excluding these studies, remission was safely achieved in a high proportion of patients in all other studies (ranging from 78.3% to 100%).…”

“…A study in a pediatric population found high relapse rates of 75% and 73% in the induction and maintenance groups, respectively, after 1 year. 42 The other 2 studies 40,41 reported relapse rates of 22% to 29% (induction group) and 31% to 44% (maintenance group) after 1 year; the difference between the groups was not statistically significant. Molnar et al found a similar relapse rate of 45% in a study of withdrawal after 3 induction doses of infliximab.…”

“…35 In 6 studies, the proportion of patients on a concomitant immunomodulator was not specified 34,[36][37][38][39] ; in the remaining studies, it ranged from 20 to 100%. Three studies [40][41][42] compared relapse rates after infliximab withdrawal after induction alone ("induction group") with relapse rates after withdrawal after at least 1 year of scheduled maintenance therapy ("maintenance group"). There were no significant differences in the rates of relapse between the induction and maintenance groups in each study, although the actual rates of relapse varied between studies.…”

Infliximab treatment time and the mucosal healing effect in pediatric patients with severe Crohn’s disease – own experience

“…We do not know if it was the effect of individual metabolism of the drug or if it was conditioned by other factors. Another problem occurring in the process of biological therapy is the fact that frequently it is necessary to intensify and prolong the treatment [18,21]. This concerns about 50% of patients, typically after 12 months of therapy, but it can happen earlier.…”

“…Even more promising results of applying the therapy in children have been published in the last two years. In French studies Wynands et al [18] observed clinical remission in the 3 rd month of therapy, after 3 IFX doses in 36 of 38 treated children (95%). Ruemmele et al [9] described such clinical effect as a result of induction therapy in 85% of patients.…”