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Infliximab therapy in 30 patients with refractory pediatric crohn disease with and without fistulas in The Netherlands.

Abstract：

OBJECTIVE:The purpose of this study was to describe the clinical experience with the anti-tumor necrosis factor chimeric monoclonal antibody, infliximab, in pediatric patients with Crohn disease in The Netherlands. DESIGN:Descriptive. METHODS:Clinical response and adverse effects of infliximab were recorded for pediatric patients with Crohn disease treated from October 1992 to January 2003. RESULTS:Thirty patients (aged 7-18 years) with refractory Crohn disease (with or without severe fistulas) were treated with infliximab. Patients were treated with up to 30 infusions. Mean follow-up was 25.3 months. A total of 212 infusions were administered. Thirteen patients had refractory Crohn disease without fistulas. Six patients showed good long-term response to infliximab treatment (defined as clinical index < or =10 points). Sixteen patients had refractory Crohn disease with draining fistulas. Nine showed good long-term response (closure or nonproductiveness of fistulas). One patient with metastatic Crohn disease in the skin had a good long-term response. Six patients developed an allergic reaction during infusion. In one patient, the allergic reaction occurred after an infliximab-free interval of 9 years. One patient died of sepsis. CONCLUSIONS:Infliximab was an effective therapy in 53% of patients with refractory pediatric Crohn disease, with or without fistulas. Approximately half of the patients become unresponsive to infliximab therapy. Randomized controlled studies are mandatory to assess long-term efficacy and safety to define the optimal therapeutic strategy of infliximab therapy in children with Crohn disease.

journal_name

J Pediatr Gastroenterol Nutr

journal_title

Journal of pediatric gastroenterology and nutrition

authors

de Ridder L,Escher JC,Bouquet J,Schweizer JJ,Rings EH,Tolboom JJ,Houwen RH,Norbruis OF,Derkx BH,Taminiau JA

doi

10.1097/00005176-200407000-00010

subject

Has Abstract

pub_date

2004-07-01 00:00:00

pages

46-52

issue

eissn

0277-2116

issn

1536-4801

pii

00005176-200407000-00010

journal_volume

pub_type

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Infliximab therapy in 30 patients with refractory pediatric crohn disease with and without fistulas in The Netherlands.