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Does Infliximab Prevent Colectomy in Acute and Chronic Active Ulcerative Colitis?

Dan-Nielsen, Steffen*; Wewer, Vibeke*; Paerregaard, Anders*; Hansen, Lars F.*; Nielsen, Rasmus G.; Lange, Aksel; Jakobsen, Christian*

Journal of Pediatric Gastroenterology and Nutrition: June 2014 - Volume 58 - Issue 6 - p 768–772
doi: 10.1097/MPG.0000000000000340
Original Articles: Gastroenterology

Objectives: The aim of the study was to evaluate clinical response, use of colectomy, and adverse events related to infliximab (IFX) treatment in acute and chronic active ulcerative colitis (UC) in children.

Methods: Children from 3 centers, who had received IFX for UC, were identified, and patient charts were reviewed retrospectively. Data concerning symptoms, biochemistry, concomitant medical treatment, colectomy, and adverse events were registered.

Results: A total of 45 patients with UC (median age at diagnosis 12 years, interquartile range 10–14) were included, and studied for a median of 15 months (interquartile range 4.5–29) after first IFX infusion. The cumulative 1- and 2-year risks of colectomy were 21% and 26%, respectively. The cumulative 1- and 2-year risks of receiving a new course of systemic corticosteroids were 32% and 48%, respectively. Twenty-one patients (46%) experienced adverse events. Most common were mild infusion reactions, but 3 (7%) had serious adverse events.

Conclusions: IFX was efficient in preventing colectomy in children with UC. The risk of receiving systemic corticosteroids was lower than that reported in other studies. Most adverse events were mild to moderate and self-limiting.

*Department of Paediatrics, Hvidovre University Hospital, Hvidovre

Hans Christian Andersen Children's Hospital, Odense

Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark.

Address correspondence and reprint requests to Steffen Dan-Nielsen, Department of Paediatrics, Hvidovre University Hospital, Kettegaard Alle 30, DK-2650 Hvidovre, Denmark (e-mail: steffendn@hotmail.com).

Received 9 February, 2014

Accepted 9 February, 2014

This study was funded in part by the Department of Paediatrics, Hvidovre University Hospital.

V.W. has served as an advisory board member for MSD. L.F.H. has given a paid lecture at a local MSD company meeting. He is the principal investigator in Denmark on the DEVELOP study. DEVELOP is sponsored by Abbott. The other authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,