Pediatr Gastroenterol Hepatol Nutr.  2017 Dec;20(4):236-243. 10.5223/pghn.2017.20.4.236.

Short-Term Outcome of Infliximab Therapy in Pediatric Crohn's Disease: A Single-Center Experience

• Jung D
• Lee S
• Jeong I
• Oh SH
• Kim KM

• KMID: 2398905
• DOI: http://doi.org/10.5223/pghn.2017.20.4.236

Abstract

PURPOSE
Studies on the efficacy of infliximab (IFX) in a large population of pediatric patients with Crohn's disease (CD) are limited, and prognostic factors are not well-known. The aim of this study was to evaluate outcomes of IFX in pediatric patients with CD and to identify factors associated with poor prognosis.
METHODS
We retrospectively analyzed medical data of 594 pediatric patients with CD between 1987 and 2013 in a tertiary center. Of these, 156 children treated with IFX were enrolled and were followed up for at least a year with intact data. Outcomes of induction and maintenance, classified as failure or clinical response, were evaluated on the tenth and 54th week of IFX therapy.
RESULTS
We treated 156 pediatric patients with CD with IFX, and the median duration of IFX therapy was 47 months. For IFX induction therapy, 134 (85.9%) patients experienced clinical response on the 10th week. Among the 134 patients who showed response to induction, 111 (82.8%) patients maintained the clinical response on the 54th week. In multivariate analysis, low hematocrit (p=0.046) at the time of IFX initiation was associated with the failure of IFX induction. For IFX maintenance therapy, longer duration from the initial diagnosis to IFX therapy (p=0.017) was associated with maintenance failure on the 54th week.
CONCLUSION
We have shown the acceptable outcomes of IFX in a large cohort of pediatric CD patients in Korea. Hematocrit and early introduction of IFX may be prognostic factors for the outcomes of IFX.

Keyword

Crohn disease; Child; Infliximab

MeSH Terms

Child
Cohort Studies
Crohn Disease*
Diagnosis
Hematocrit
Humans
Infliximab*
Korea
Multivariate Analysis
Prognosis
Retrospective Studies
Infliximab

Figure

• 

  Fig. 1 Flow diagram of enrolled patients.

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  Fig. 2 Efficacy of infliximab in pediatric Crohn's disease.

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  Fig. 3 Distribution of patients by interval from diagnosis to infliximab (IFX) injection. The median interval from diagnosis to IFX injection was 44.5 (range, 0–236) months, which is indicated by the green line. The optimal cut-off point (29 months), marked by the blue line, was derived from the receiver operating characteristic curve.

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