Long-Term Durability of Infliximab for Pediatric Ulcerative Colitis: A Retrospective Data Review in a Tertiary Children's Hospital in Japan

Hirotaka Shimizu; Katsuhiro Arai; Ichiro Takeuchi; Kei Minowa; Kenji Hosoi; Masamichi Sato; Itsuhiro Oka; Yoichiro Kaburaki; Toshiaki Shimizu

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자료유형: 학술저널

저자정보: Hirotaka Shimizu (National Center for Child Health and Development) Katsuhiro Arai (National Center for Child Health and Development) Ichiro Takeuchi (National Center for Child Health and Development) Kei Minowa (National Center for Child Health and Development) Kenji Hosoi (National Center for Child Health and Development) Masamichi Sato (National Center for Child Health and Development) Itsuhiro Oka (National Center for Child Health and Development) Yoichiro Kaburaki (National Center for Child Health and Development) Toshiaki Shimizu (Juntendo University Graduate School of Medicine)

저널정보: 대한소아소화기영양학회 Pediatric Gastroenterology, Hepatology & Nutrition Pediatric Gastroenterology, Hepatology & Nutrition 제24권 제1호

발행연도: 2021.1

수록면: 7 - 18 (12page)

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Purpose: The long-term efficacy and safety of infliximab (IFX) in children with ulcerative colitis (UC) have not been well-evaluated. Here, we reviewed the long-term durability and safety of IFX in our single center pediatric cohort with UC. Methods: This retrospective study included 20 children with UC who were administered IFX. Results: For induction, 5 mg/kg IFX was administered at weeks 0, 2, and 6, followed by every 8 weeks for maintenance. The dose and interval of IFX were adjusted depending on clinical decisions. Corticosteroid (CS)-free remission without dose escalation (DE) occurred in 30% and 25% of patients at weeks 30 and 54, respectively. Patients who achieved CS-free remission without DE at week 30 sustained long-term IFX treatment without colectomy. However, one-third of the patients discontinued IFX treatment because of a primary nonresponse, and one-third experienced secondary loss of response (sLOR). IFX durability was higher in patients administered IFX plus azathioprine for >6 months. Four of five patients with very early onset UC had a primary nonresponse. Infusion reactions (IRs) occurred in 10 patients, resulting in discontinuation of IFX in four of these patients. No severe opportunistic infections occurred, except in one patient who developed acute focal bacterial nephritis. Three patients developed psoriasis-like lesions. Conclusion: IFX is relatively safe and effective for children with UC. Clinical remission at week 30 was associated with long-term durability of colectomy-free IFX treatment. However, approximately two-thirds of the patients were unable to continue IFX therapy because of primary nonresponse, sLOR, IRs, and other side effects.

#Dose escalation #Infliximab #Child #Remission #Ulcerative colitis

참고문헌 (19)

참고문헌 신청

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Van Limbergen J / 2008 / Definition of phenotypic characteristics of childhood-onset inflammatory bowel disease / Gastroenterology 135:1114~1122

Hyams JS / 2010 / Outcome following infliximab therapy in children with ulcerative colitis / Am J Gastroenterol 105:1430~1436

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