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Infliximab Safe and Effective in Children With Ulcerative Colitis

Am J Gastroenterol 2010.

Infliximab provides good short- and long-term outcomes in children with refractory ulcerative colitis (UC), a new study shows.

"Infliximab should be considered as a first line rescue therapy in children who continue to be symptomatic despite steroids, and in those who remain corticosteroid dependent despite immunomodulators," lead investigator Dr. Jeffrey S. Hyams, of Connecticut Children's Medical Center, Hartford, told Reuters Health in an email.

Using data from the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry, he and his colleagues studied 52 children who received infliximab for refractory or steroid-dependent disease.

According to their January 26th online report in the American Journal of Gastroenterology, the mean age at infliximab initiation was 13 years. Treatment started <3 months from diagnosis in 12 patients, between 3 and 12 months in 20, and >12 months in 20. At the time of the first infusion, 51% of the children were taking 5-aminosalicylates, 87% were taking corticosteroids, and 63% were taking thiopurines.

Rates of corticosteroid-free inactive disease at 6, 12 and 24 months were 27% (12/44), 38% (15/39), and 21% (6/28), according to the authors.

On Kaplan-Meier analysis, the likelihood of remaining colectomy-free after infliximab treatment was 75% at 6 months, 72% at 12 months, and 61% at 24 months.

There were no treatment-emergent serious adverse events.

"The numbers are still sobering as there are children who do not respond to our current therapies, including infliximab, and go on to colectomy," Dr. Hyams concluded. "Clearly additional agents are required."