title: Response to infliximab is related to disease duration in paediatric Crohn's disease.
abstract: BACKGROUND
  Infliximab is an effective therapy in adult patients with refractory and fistulizing Crohn's disease. Experience in children is still limited.
  
  
  OBJECTIVE
  : To evaluate the experience in 22 children and adolescents treated with infliximab with refractory and/or fistulizing Crohn's disease, and to compare duration of response in children between early Crohn's disease and late Crohn's disease.
  
  
  METHODS
  The experience in 22 children and adolescents treated with a total of 73 infusions was evaluated retrospectively. Treatment indication was refractory Crohn's disease in 9/22 patients, fistulizing Crohn's disease in 7/22 patients and both these conditions in 6/22. All patients with refractory Crohn's disease had late Crohn's disease (> 1 year), whereas 6/13 patients with fistulas had early disease (< 1 year).
  
  
  RESULTS
  Mean Paediatric Crohn's Disease Activity Index (PCDAI) decreased from 41.2 to 16.2 at 4 weeks (P < 0.01), and to 15.4 at 18 weeks (P < 0.01). Mean PCDAI at 18 weeks in children with early Crohn's disease and late Crohn's disease was 5.5 and 18.1, respectively (P < 0.05). Complete closure of fistulas was obtained in 5/6 children with early Crohn's disease and in 2/7 children with late Crohn's disease. Immediate adverse reactions were observed in two children.
  
  
  CONCLUSIONS
  Infliximab is a highly effective treatment in children and adolescents with both severe refractory or fistulizing Crohn's disease. Children with early Crohn's disease have a higher chance of prolonged response to infliximab than children with late Crohn's disease.
authors.affiliation: Dipartimento di Pediatria, Università di Firenze-Ospedale Meyer, Florence, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Lionetti
authors.forename: F
authors.initials: F
authors.lastname: Bronzini
authors.forename: C
authors.initials: C
authors.lastname: Salvestrini
authors.forename: C
authors.initials: C
authors.lastname: Bascietto
authors.forename: R Berni
authors.initials: RB
authors.lastname: Canani
authors.forename: G L
authors.initials: GL
authors.lastname: Dé Angelis
authors.forename: G
authors.initials: G
authors.lastname: Guariso
authors.forename: S
authors.initials: S
authors.lastname: Martelossi
authors.forename: B
authors.initials: B
authors.lastname: Papadatou
authors.forename: A
authors.initials: A
authors.lastname: Barabino
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D007412:Intestinal Fistula / Q000150:complications* / Q000188:drug therapy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab