Infliximab improves inflammation and anthropometric measures in pediatric Crohn's disease.
OBJECTIVE
Infliximab (IFX) is a monoclonal antibody licensed to treat medically refractory Crohn's disease (CD). Our aim was to elucidate the effects of IFX therapy on clinical, growth and serum parameters in children with CD in a single pediatric center in Sydney, Australia.


METHODS
A retrospective case series review of children treated with IFX for CD at Sydney Children's Hospital, Australia was undertaken, with a review of outcomes after starting IFX. Main outcome measures were response and remission (as measured according to improvements in Pediatric Crohn's Disease Activity Index scores and Physician Global Assessment), laboratory markers (C-reactive protein, erythrocyte sedimentation rate, hemoglobin, white cell count, lymphocytes, neutrophils, platelets, albumin) and growth (Z scores).


RESULTS
The 16 patients included had a mean age at first infusion of 13.0 years (1.25-17.5 years). Six of 12 patients (with adequate data available) were in remission at 2 weeks following the first infusion. At 1 year, 10 of 12 patients (83%) were in remission. Mean C-reactive protein and erythrocyte sedimentation rate had fallen significantly (P < 0.05) at 2 weeks (from 29 to 7 mg/L and 40 to 19 mm/h, respectively). Positive trends were observed for all other parameters, excluding lymphocytes and white cell count. At 1 year, mean Z score for body mass index improved significantly from -0.9 to -0.1 (P < 0.01).


CONCLUSIONS
Disease activity subsides in most children treated with IFX for CD. IFX therapy also improves some growth parameters. The pattern of improvement requires further elucidation, as the results in the present study suggest differing dosing frequency of infusion may achieve better efficacy.
Sinitsky
Daniel M
DM
Department of Gastroenterology, Sydney Children's Hospital, Sydney, Australia.
Lemberg
Daniel A
DA
Leach
Steven T
ST
Bohane
Timothy D
TD
Jackson
Reuben
R
Day
Andrew S
AS
D000293:Adolescent; D000886:Anthropometry; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000097:blood*; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D009517:New South Wales; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D015415:Biomarkers; D005765:Gastrointestinal Agents; D018836:Inflammation Mediators; D000069285:Infliximab