title: Outcome following infliximab therapy in children with ulcerative colitis.
abstract: OBJECTIVE
  Infliximab is effective in treating moderate/severe ulcerative colitis (UC) in adults. The aim of this study was to determine the outcome after treatment with infliximab in pediatric UC.
  
  
  METHODS
  We performed a multicenter cohort study of 332 pediatric patients with UC enrolled in the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry. Children<or=16 years of age and newly diagnosed with UC are enrolled in the registry. Disease and medication information are collected prospectively from the treating physician at diagnosis, 30 days, and quarterly thereafter. No interventions were specified, per protocol.
  
  
  RESULTS
  Of 332 patients, 52 (16%) received infliximab (23%<3 months from diagnosis, 38% 3-12 months, 38% >12 months). Mean age at infliximab initiation was 13.3+/-2.6 (range 6-17) years; 87% of patients had pancolitis. Median follow-up was 30 months. Continuous maintenance (CM) therapy was given in 65%, episodic in 21%, episodic converted to CM in 6%, and insufficient data in 8% of patients. Sixty-three percent of patients were corticosteroid refractory, and 35% were corticosteroid dependent. Concomitant medications at first infliximab infusion included corticosteroids (87%), thiopurines (63%), and 5-aminosalicylates (51%). Corticosteroid-free inactive disease by physician global assessment was noted in 12/44 (27%), 15/39 (38%), and 6/28 (21%) patients at 6, 12, and 24 months, respectively. Kaplan-Meier analysis showed that the likelihood of remaining colectomy free after treatment with infliximab was 75% at 6 months, 72% at 12 months, and 61% at 2 years.
  
  
  CONCLUSIONS
  In this cohort of children with UC receiving infliximab, corticosteroid-free inactive disease was observed in 38 and 21% of patients at 12 and 24 months, respectively. By 24 months, 61% of patients had avoided colectomy.
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA. jhyams@ccmckids.org
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hyams
authors.forename: Trudy
authors.initials: T
authors.lastname: Lerer
authors.forename: Anne
authors.initials: A
authors.lastname: Griffiths
authors.forename: Marian
authors.initials: M
authors.lastname: Pfefferkorn
authors.forename: Michael
authors.initials: M
authors.lastname: Stephens
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.forename: Anthony
authors.initials: A
authors.lastname: Otley
authors.forename: Ryan
authors.initials: R
authors.lastname: Carvalho
authors.forename: David
authors.initials: D
authors.lastname: Mack
authors.forename: Athos
authors.initials: A
authors.lastname: Bousvaros
authors.forename: Joel
authors.initials: J
authors.lastname: Rosh
authors.forename: Andrew
authors.initials: A
authors.lastname: Grossman
authors.forename: Gitit
authors.initials: G
authors.lastname: Tomer
authors.forename: Marsha
authors.initials: M
authors.lastname: Kay
authors.forename: Wallace
authors.initials: W
authors.lastname: Crandall
authors.forename: Maria
authors.initials: M
authors.lastname: Oliva-Hemker
authors.forename: David
authors.initials: D
authors.lastname: Keljo
authors.forename: Neal
authors.initials: N
authors.lastname: LeLeiko
authors.forename: James
authors.initials: J
authors.lastname: Markowitz
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab