Outcome following infliximab therapy in children with ulcerative colitis

Jeffrey S. Hyams, Trudy Lerer, Anne Griffiths, Marian Pfefferkorn, Michael Stephens, Jonathan Evans, Anthony Otley, Ryan Carvalho, David MacK, Athos Bousvaros, Joel Rosh, Andrew Grossman, Gitit Tomer, Marsha Kay, Wallace Crandall, Maria Oliva-Hemker, David Keljo, Neal Leleiko, James Markowitz

Research output: Contribution to journalArticle

93 Scopus citations

Abstract

Objectives: Infliximab is effective in treating moderate/severe ulcerative colitis (UC) in adults. The aim of this study was to determine the outcome after treatment with infliximab in pediatric UC.Methods: We performed a multicenter cohort study of 332 pediatric patients with UC enrolled in the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry. Children ≥ 16 years of age and newly diagnosed with UC are enrolled in the registry. Disease and medication information are collected prospectively from the treating physician at diagnosis, 30 days, and quarterly thereafter. No interventions were specified, per protocol.Results: Of 332 patients, 52 (16%) received infliximab (23% >3 months from diagnosis, 38% 3-12 months, 38% >12 months). Mean age at infliximab initiation was 13.3±2.6 (range 6-17) years; 87% of patients had pancolitis. Median follow-up was 30 months. Continuous maintenance (CM) therapy was given in 65%, episodic in 21%, episodic converted to CM in 6%, and insufficient data in 8% of patients. Sixty-three percent of patients were corticosteroid refractory, and 35% were corticosteroid dependent. Concomitant medications at first infliximab infusion included corticosteroids (87%), thiopurines (63%), and 5-aminosalicylates (51%). Corticosteroid-free inactive disease by physician global assessment was noted in 12/44 (27%), 15/39 (38%), and 6/28 (21%) patients at 6, 12, and 24 months, respectively. Kaplan-Meier analysis showed that the likelihood of remaining colectomy free after treatment with infliximab was 75% at 6 months, 72% at 12 months, and 61% at 2 years.Conclusions: In this cohort of children with UC receiving infliximab, corticosteroid-free inactive disease was observed in 38 and 21% of patients at 12 and 24 months, respectively. By 24 months, 61% of patients had avoided colectomy.

Original languageEnglish (US)
Pages (from-to)1430-1436
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume105
Issue number6
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Hyams, J. S., Lerer, T., Griffiths, A., Pfefferkorn, M., Stephens, M., Evans, J., Otley, A., Carvalho, R., MacK, D., Bousvaros, A., Rosh, J., Grossman, A., Tomer, G., Kay, M., Crandall, W., Oliva-Hemker, M., Keljo, D., Leleiko, N., & Markowitz, J. (2010). Outcome following infliximab therapy in children with ulcerative colitis. American Journal of Gastroenterology, 105(6), 1430-1436. https://doi.org/10.1038/ajg.2009.759