title: Long-term outcome of treatment with infliximab in pediatric-onset Crohn's disease: a population-based study.
abstract: BACKGROUND
  We examined short- and long-term benefits and safety of infliximab (IFX) in a population-based cohort of Crohn's disease (CD) patients <17 years old at diagnosis.
  
  
  METHODS
  The following parameters were assessed: short- and long-term efficacy of IFX, impact of drug efficacy, and mode of administration on rate of resection surgery, growth and nutritional catch-up, and adverse events (AEs).
  
  
  RESULTS
  In all, 120 patients (69 female) required IFX with a median duration of 32 months (Q1 = 8-Q3 = 60). Median age at diagnosis was 14.5 years (12-16) and median interval between diagnosis and IFX initiation was 41 months (22-78). Median follow-up since CD diagnosis was 111 months (75-161). Fifty patients (42%) received episodic and 70 (58%) maintenance therapy. Sixty-five (54%) patients were in the "IFX efficacy" group: 38 (32%) still receiving IFX at the last visit and 27 (22%) stopping IFX while in remission. The "IFX failure" group included 55 (46%) patients: 17 (14%) who stopped IFX due to AEs and 38 (32%) nonresponders. The risk of surgery was reduced (P = 0.009) in the "IFX efficacy" group and lower (P = 0.03) in patients with scheduled versus episodic therapy. Patients in the "IFX efficacy" group had significant catch-up growth (P = 0.04), while those in the "IFX failure" group did not. Twenty-four patients presented AEs leading to cessation of IFX in 17 of them.
  
  
  CONCLUSIONS
  In this population-based cohort of pediatric-onset CD, IFX treatment was effective in more than half of patients during a median follow-up of 32 months. Long-term IFX responders had a lower rate of surgery and improved catch-up in growth, especially when receiving scheduled IFX therapy.
authors.affiliation: Gastroenterology Unit, EPIMAD Registry, Lille University Hospital, Lille, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Crombé
authors.forename: Julia
authors.initials: J
authors.lastname: Salleron
authors.forename: Guillaume
authors.initials: G
authors.lastname: Savoye
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Dupas
authors.forename: Gwénola
authors.initials: G
authors.lastname: Vernier-Massouille
authors.forename: Eric
authors.initials: E
authors.lastname: Lerebours
authors.forename: Antoine
authors.initials: A
authors.lastname: Cortot
authors.forename: Véronique
authors.initials: V
authors.lastname: Merle
authors.forename: Francis
authors.initials: F
authors.lastname: Vasseur
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
authors.forename: Corinne
authors.initials: C
authors.lastname: Gower-Rousseau
authors.forename: Marc
authors.initials: M
authors.lastname: Lémann
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Colombel
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D012074:Remission Induction; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab