title: Induction and maintenance infliximab therapy in children with moderate to severe ulcerative colitis: Retrospective, multicenter study.
abstract: BACKGROUND
  Pediatric ulcerative colitis (UC) is a severe disease characterised by the presence of extensive inflammatory lesions in the colon. The administration of intravenous corticosteroids is recommended in patients with acute relapse of the disease, whereas early treatment with cyclosporine, tacrolimus or infliximab is recommended if there is no improvement.
  
  
  OBJECTIVE
  The aim of this study was to retrospectively evaluate the efficacy and safety of infliximab therapy in the treatment of moderate-to-severe and severe relapse of pediatric UC.
  
  
  METHODS
  The analysis included 42 children aged 4-18 years (23 girls, 19 boys) treated in 7 pediatric gastroenterology departments in Poland during the past 4 years. The disease duration ranged from 2 to 100 months. The clinical activity of UC ranged from 35 to 85 points according to the PUCAI scale. Twenty-one children were diagnosed with pancolitis, 10 children with extensive UC, and the remaining with the left-sided UC. In the induction therapy infliximab was administered at doses of 5 mg/kg in the 0.2 and 6 weeks, and after the clinical response every 8 weeks to 12 months. Treatment results were assessed in 10 and 54 weeks.
  
  
  RESULTS
  After the induction therapy the clinical response was achieved in 14 children (33.33%) and clinical remission in 11 children (26.19%). Two children required surgical treatment, and the remaining 2 suffered from anaphylactic shock. After the maintenance therapy clinical remission was maintained in 12 children (57.14%), whereas 3 children required surgery (colectomy).
  
  
  CONCLUSIONS
  Infliximab therapy in children with moderate-to-severe UC induces remission and, in some children, proves to be effective in preventing early colectomy.
authors.affiliation: 2nd Department of Paediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Iwańczak
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kierkuś
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Józef
authors.initials: J
authors.lastname: Ryżko
authors.affiliation: Department of Pediatric Gastroenterology and Metabolic Disorders, Poznan University of Medical Science, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Szczepanik
authors.affiliation: Department of Pediatrics, Medical University of Silesia, Gastroenterology Unit, Upper Silesian Child Health Care Center, Katowice, Poland.
authors.forename: Sabina
authors.initials: S
authors.lastname: Więcek
authors.affiliation: Pediatric Nursery Unit of Pomeranian Medical University, Division of Pediatrics, Gastroenterology and Reumatology of Zdroje Hospital, Szczecin, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Czaja-Bulsa
authors.affiliation: Pediatric Nursery Unit of Pomeranian Medical University, Division of Pediatrics, Gastroenterology and Reumatology of Zdroje Hospital, Szczecin, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kacperska
authors.affiliation: Department of Pediatrics, State Hospital no. 2, Rzeszów, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Korczowski
authors.affiliation: Province Children's Hospital, Kielce, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Maślana
authors.affiliation: 2nd Department of Paediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
authors.forename: Franciszek
authors.initials: F
authors.lastname: Iwańczak
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D060828:Induction Chemotherapy; D000069285:Infliximab / Q000627:therapeutic use*; D060046:Maintenance Chemotherapy; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab
keywords: children; infliximab; ulcerative colitis