Avoidance of steroids by the early use of infliximab and 6-mercaptopurine in an adolescent with active Crohn's colitis

Persley, Kimberly M.; Scherl, Ellen; Rubin, Peter

doi:10.1111/j.1572-0241.2001.05380.x

Cited by 7 publications

(2 citation statements)

References 17 publications

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“…Early use of infliximab can reduce the requirement of corticosteroids and its eventual side-effects. 8 In this case report, case 3 received infliximab early in the course of illness to allow early withdrawal of corticosteroids. In addition, in case 2 who had severe adverse effects from prolonged corticosteroids therapy with proximal muscle weakness, severe lymphopenia, and early cataract, the corticosteroids were stopped within 4 months of commencement of infliximab treatment.…”

Section: Discussionmentioning

confidence: 99%

The use of infliximab in South‐east Asian children with severe Crohn's disease

Lee¹

2004

Pediatrics International

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Section: Discussionmentioning

confidence: 99%

The use of infliximab in South‐east Asian children with severe Crohn's disease

Lee¹

2004

Pediatrics International

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“…A statistically higher efficacy of infliximab, if started according to the top-down strategy (remission attained in 74.5% [top-down] vs 48.1% [step-up], P ¼ 0.006), was shown (73). In 2001 an adolescent with CD treated with 2 infusions of infliximab as first-line therapy (without corticosteroids) achieving clinical remission was described (74). A report of a corticosteroid-naı ¨ve 12-year-old girl with severe Crohn colitis (PCDAI 60) who was treated with infliximab maintenance and azathioprine as first-line treatment (top-down vs step-up) was recently published in JPGN (75).…”

Section: Early Use Of Infliximab and Avoidance Of Corticosteroidsmentioning

confidence: 99%

Infliximab Use in Children and Adolescents With Inflammatory Bowel Disease

Ridder

Benninga

Taminiau

et al. 2007

J. pediatr. gastroenterol. nutr.

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Infliximab is a chimeric monoclonal antibody (75% human, 25% murine) against tumor necrosis factor-alpha, a cytokine with a central role in the pathogenesis of inflammatory bowel disease. Large randomized controlled trials have shown the efficacy and safety of infliximab for the induction and maintenance of remission in adult patients with active Crohn disease (CD). In children and adolescents, mostly small, nonrandomized, non-placebo-controlled studies have supported the notion that infliximab is a potent drug in a population that does not respond to standard therapies. The safety of infliximab is of major concern, and the most frequent severe adverse events are related to severe infections and reactivation of tuberculosis. Non-life-threatening infusion reactions occur rather frequently and seem to be related to the formation of antibodies. The indications for infliximab treatment are therapy-resistant luminal CD (no efficacy or insufficient efficacy of conventional treatment) and therapy-resistant fistulas. An efficient remission induction strategy consists of 3 initial infliximab infusions at 0, 2, and 6 weeks in a dosage of 5 mg/kg to sustain remission. Patients needing maintenance therapy are subsequently treated with an infliximab infusion every 8 weeks. There are indications that the early stages of CD may be more susceptible to immunomodulation, and the natural history of CD may be altered by the introduction of infliximab early in the disease process instead of waiting until conventional therapy has failed. Major points of discussion are whether infliximab maintenance treatment should be episodic (on demand) or scheduled and when infliximab therapy can be discontinued.

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Infliximab dependency in pediatric Crohnʼs disease: Long-term follow-up of an unselected cohort

Ridder

Rings

Damen

et al. 2008

Inflammatory Bowel Diseases

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Good clinical response to maintenance infliximab therapy was seen in 70% of patients. Infliximab maintenance therapy seems very effective and safe in pediatric CD. However, more than half of the patients in this cohort is dependent on repeated infliximab infusions. The number of infliximab infusions received when patients lost response to infliximab was diverse. There was no statistical difference regarding response to infliximab therapy when started early as compared to later in the course of Crohn's disease.

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Avoidance of steroids by the early use of infliximab and 6-mercaptopurine in an adolescent with active Crohn's colitis

Cited by 7 publications

References 17 publications

The use of infliximab in South‐east Asian children with severe Crohn's disease

The use of infliximab in South‐east Asian children with severe Crohn's disease

Infliximab Use in Children and Adolescents With Inflammatory Bowel Disease

Infliximab dependency in pediatric Crohnʼs disease: Long-term follow-up of an unselected cohort

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