title: Autoregressive cross-lagged models of IMPACT-III and Pediatric Crohn's Disease Activity Indexes during one year infliximab therapy in pediatric patients with Crohn's disease.
abstract: BACKGROUND
  Quality of life (QoL) is an important outcome measure in the evaluation of therapies for inflammatory bowel disease. The primary aim of this study was to determine the effect of one year infliximab treatment on QoL and clinical parameters in pediatric patients with Crohn's diseases (CD).
  
  
  METHODS
  Our prospective study involved 51 children with conventional therapy resistant, severe CD (mean age: 15.25years, range: 11-18years). Infliximab was given according to the protocol (5mg/kg, at weeks 0, 2, 6 and every 8weeks). During the infliximab courses QoL of patients was evaluated by IMPACT-III questionnaire at weeks 0, 6, 30 and 53. At the same time, the Pediatric Crohn's Disease Activity Index (PCDAI) score was calculated. Moreover, serum C-reactive protein (CRP), serum platelets and serum albumin were followed up. Auto-regressive, cross-lagged models were used to assess relation between QoL and the clinical parameters.
  
  
  RESULTS
  The initial IMPACT-III scores [median, percentile 25-75 (pc 25-75) at week 0: 115, 102.5-130.25] increased significantly (p<0.001) following infliximab therapy at week 54 (median: 141.5, 124.5-153.75). Clinical and laboratory parameters also improved significantly (p<0.001). Auto-regressive regression coefficients (β value) were significant between each variable over time. The strongest cross-lagged relations were observed between IMPACT-III and serum albumin, IMPACT-III and platelets. Reliability test of IMPACT-III revealed an excellent level of internal consistency (Cronbach's alpha=0.931).
  
  
  CONCLUSIONS
  Infliximab treatment has beneficial clinical effect which is confirmed by decrease of PCDAI and increase of IMPACT-III. Autoregressive regression analysis showed regression relation between IMPACT-III and PCDAI and laboratory parameters.
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Dolóresz
authors.initials: D
authors.lastname: Szabó
authors.affiliation: Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
authors.forename: Gyöngyi
authors.initials: G
authors.lastname: Kökönyei
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Arató
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Antal
authors.initials: A
authors.lastname: Dezsőfi
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Kriszta
authors.initials: K
authors.lastname: Molnár
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Katalin Eszter
authors.initials: KE
authors.lastname: Müller
authors.affiliation: 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Péter László
authors.initials: PL
authors.lastname: Lakatos
authors.affiliation: 2nd Department of Medicine, University of Debrecen, Debrecen, Hungary.
authors.forename: Mária
authors.initials: M
authors.lastname: Papp
authors.affiliation: 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Lovász
authors.affiliation: 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Petra A
authors.initials: PA
authors.lastname: Golovics
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Aron
authors.initials: A
authors.lastname: Cseh
authors.affiliation: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary. Electronic address: veres.gabor@med.semmelweis-univ.hu.
authors.forename: Gábor
authors.initials: G
authors.lastname: Veres
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000069285:Infliximab
keywords: Autoregressive cross-lagged analysis; Crohn's disease; IMPACT-III; Infliximab; Pediatric