Infliximab Efficacy in Pediatric Ulcerative Colitis

Abstract

Infliximab should be considered in the treatment of children with symptoms of acute moderate to severe ulcerative colitis.

Outcomes and adverse events in children and young adults undergoing tacrolimus therapy for steroid-refractory colitis

“…5 Published experience with infliximab in pediatric disease is increasing, but there are still a significant number of children who do not respond to this medication (Table 4). [22][23][24][25][26] Cyclosporine is effective in adults with colitis, 27 but usually is given intravenously, requires careful monitoring, and has unpleasant side effects such as hirsutism and gingival hyperplasia. 28 Tacrolimus offers several advantages for children, including oral administration and fewer cosmetic side effects than cyclosporine.…”

Management of Acute Severe Colitis in Children With Ulcerative Colitis in the Biologics Era

“…Eidelwein et al 35 showed an initial short-term response to infliximab in pediatric UC: 75% had complete resolution of symptoms, and 25% improved after initial infusion; many of these patients continued to respond in the subsequent 6 months, but one-third of children underwent colectomy. The authors concluded that infliximab is a valid alternative therapy to cyclosporine or colectomy in patients requiring chronic CS therapy or not responding to 6-MP or azathioprine.…”

“…Surgery is unavoidable in these patients, and time delay in nonresponders to medical therapy is associated with an increased risk of postoperative complications. 35 Indications for surgery, other than ASC, include toxic megacolon, perforation, severe hemorrhage, or significant clinical deterioration during medical therapy. Although in general, medical rescue therapy should be considered as first-line treatment in steroid-refractory ASC, colectomy is still a cornerstone of any proposed management algorithm.…”

Behandlung chronisch entzündlicher Darmerkrankungen bei Kindern und Jugendlichen

“…Hierfür spricht auch eine retrospektive Studie von Eidelwein et al [9], die allerdings nur wenige Patienten einschloss. 12 Colitis-ulcerosa-Patienten erhielten IFX, 3 mit fulminantem Verlauf, 3 mit akuter Exazerbation, 5 mit Steroidabhängig-keit und einer mit steroidrefraktärer Colitis ulcerosa.…”