title: [Efficacy of infliximab in treatment of pediatric Crohn's disease in China].
abstract: OBJECTIVE
  To investigate the efficacy of infliximab versus corticosteroids in achieving clinical remission in pediatric patients with Crohn's disease in China.
  
  
  METHODS
  Data of all newly diagnosed active Crohn's disease pediatric cases seen from June 2009 to December 2013 in Children's Hospital, Zhejiang University School of Medicine were retrospectively recorded and reviewed.
  
  
  METHODS
  the age of the children was less than 18 years; pediatric Crohn's disease activity index (PCDAI) was more than 10; infliximab or corticosteroids were used for inducing remission; infliximab, immunosuppressive medications or mesalamine was prescribed for maintaining remission. Patients in steroids group were followed up for more than 1 year. The enrolled patients were divided into two groups: infliximab group and steroids group. Clinical data, laboratory findings and side effects of the medications were collected at week 2, 4, 12, 24 and 48. PCDAI and Crohn's disease endoscopic index score (CDEIS) were calculated. Clinical response rate, clinical remission rate, relapse rate, mucosal healing and growth were evaluated.
  
  
  RESULTS
  Eleven children received infliximab therapy and 11 subjects received corticosteroids. In Infliximab group, 6, 5 and 7 patients were in clinical remission at week 2, 4, and 8, while so were 6, 9, and 9 patients in steroids group. The difference was not statistically significant (χ² = 0.00, 3.14, 0.92, P > 0.05). In infliximab group, 8, 8, and 11 patients were in clinical remission at week 2, 4, and 8, so were 8, 9, and 9 patients in steroids group. The difference was not statistically significant (χ² = 0.00,0.26, 2.20, P > 0.05). When compared with data at baseline, significant decreases were observed in the median PCDAI between the two groups at week 2, 4, and 8 (all P < 0.05). But there were no significant differences between two groups at week 2, 4, and 8 (all P > 0.05). At week 12, 24 and 48, 8/11, 7/8, 3/5 cases on infliximab versus 7/11, 9/11, 8/11 cases on steroids maintained remission. There was no significant differences between the two groups (all P > 0.05). In 7 patients and 9 patients remission was successfully induced at week 8. The relapse rate was similar at week 12, 24, and 48 (χ² = 0.83, 0.09, 1.00, all P > 0.05). Height for age Z score in infliximab group was significantly higher than that in steroids group at week 24 (P < 0.05). Body mass index Z score between the two groups at week 8, 24, and 48 were not statistically significant (all P > 0.05). Of the children treated with infliximab, 3 developed side effects. All the children treated with steroids got Cushing's syndrome.
  
  
  CONCLUSIONS
  In children with Crohn's disease, infliximab therapy is as effective as corticosteroids to induce remission.Less side effects were observed with infliximab therapy compared with immunosuppressive medication and mesalamine.
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Youyou
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Jindan
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Kerong
authors.initials: K
authors.lastname: Peng
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Jingan
authors.initials: J
authors.lastname: Lou
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Ma
authors.affiliation: Department of Gastroenterology, the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China. Email: hzcjie@zju.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002648:Child; D002681:China; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D000069285:Infliximab; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000069285:Infliximab