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Efficacy of early treatment with infliximab in pediatric crohn’s disease

World Journal of Gastroenterology 2010年第14期16卷 1776-1781页

作者： Jong seung Lee Jee Hyun Lee Ji Hyuk Lee Hye Jin Lee Mi Jin Kim Hae Jeong Lee Yon Ho Choe Department of pediatrics College of Medicine Chung-Ang University Yongsan Hospital Yongsan Seoul 140-757 South Korea Department of pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Gangnam Seoul 135-710 South Korea

AIM: To investigate the effectiveness of early infliximab use for induction and maintenance therapy in pediatric crohn’s disease. METHODs: We performed a retrospective chart review of 36 patients with crohn’s disease. Ten patients (group A) were treated with mesalamine after induction therapy with oral prednisolone, and 13 patients (group B) were treated with azathioprine after induction therapy with oral prednisolone. Thirteen patients (group C) received infliximab and azathioprine for induction and maintenance therapy for the first year, and were treated with azathioprine after 1 year. All patients were followed for at least 24 mo. Efficacy was determined by the relapse rate using the pediatric crohn’s disease activity index score in each group at 12 and 24 mo. REsULTs: At the 1 year follow-up, the relapse ratee, Mi Jin Kim, Hae Jeong Lee, Yon Ho Choe (23.1%, 3 of 13 patients) in group C was lower than that (61.5%, 8 of 13 patients) in group B (P = 0.047). At the 2 years follow-up, the relapse rate (38.5%, 5 of 13 patients) in group C was lower than that (76.9%, 10 of 13 patients) in group B (P = 0.047). Adverse events in group C were fewer than in groups A and B. CONCLUsION: Early induction with infliximab at diagnosis, known as "top-down" therapy, was effective for reducing the relapse rate compared to conventional therapies for at least 2 years.

关键词： Efficacy Infliximab pediatric crohn’s disease Relapse rate Top-down treatment

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