Adalimumab therapy in children with Crohn disease previously treated with infliximab
| Autor: | Cozijnsen, M., Duif, V., Kokke, F., Kindermann, A., Rheenen, P. van, Meij, T. de, Schaart, M., Damen, G., Norbruis, O., Pelleboer, R., Neucker, A. van den, Wering, H. van, Hummel, T., Oudshoorn, J., Escher, J., Ridder, L. de, Dutch PIBD Working Grp Kids Crohn |
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| Přispěvatelé: | AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Gastroenterology, Other departments, Kindergeneeskunde, RS: FHML non-thematic output, Pediatrics, Pediatric surgery, CCA - Innovative therapy, Center for Liver, Digestive and Metabolic Diseases (CLDM) |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty paediatric Adolescent Drug Resistance Antibodies Monoclonal Humanized IMMUNOGENICITY Gastroenterology Inflammatory bowel disease Severity of Illness Index Pharmacotherapy Interquartile range Internal medicine adalimumab medicine Adalimumab Humans Treatment Failure Adverse effect Child Retrospective Studies business.industry INDUCTION Hazard ratio Anti-Inflammatory Agents Non-Steroidal Antibodies Monoclonal Crohn disease Drug Tolerance medicine.disease EFFICACY Ulcerative colitis Infliximab Surgery MAINTENANCE ULCERATIVE-COLITIS SAFETY Pediatrics Perinatology and Child Health Retreatment Drug Therapy Combination Female TRIAL business infliximab biological medicine.drug INFLAMMATORY-BOWEL-DISEASE |
| Zdroj: | Journal of pediatric gastroenterology and nutrition, 60(2), 205-210. Lippincott Williams and Wilkins Journal of Pediatric Gastroenterology and Nutrition, 60(2), 205-210. LIPPINCOTT WILLIAMS & WILKINS Journal of Pediatric Gastroenterology and Nutrition, 60(2), 205-210. Lippincott Williams & Wilkins Journal of Pediatric Gastroenterology and Nutrition, 60(2), 205-210 Journal of Pediatric Gastroenterology and Nutrition, 60(2), 205-210. Lippincott Williams and Wilkins Cozijnsen, M, Duif, V, Kokke, F, Kindermann, A, van Rheenen, P, de Meij, T G J, Schaart, M, Damen, G, Norbruis, O, Pelleboer, R, Van den Neucker, A, van Wering, H, Hummel, T, Oudshoorn, J, Escher, J & de Ridder, L 2015, ' Adalimumab Therapy in Children With Crohn Disease Previously Treated With Infliximab ', Journal of Pediatric Gastroenterology and Nutrition, vol. 60, no. 2, pp. 205-210 . https://doi.org/10.1097/MPG.0000000000000589 |
| ISSN: | 0277-2116 |
| DOI: | 10.1097/mpg.0000000000000589 |
| Popis: | Objectives: Adalimumab, a humanised anti-tumour necrosis factor antibody, is an effective treatment in adult patients with refractory Crohn disease (CD). The available literature on its efficacy in children remains limited. We aimed to evaluate the real-world efficacy in paediatric patients with CD and compare the efficacy between infliximab (IFX) nonresponders and patients who lost response to IFX.Methods: All Dutch patients with CD receiving adalimumab before the age of 18 years after previous IFX therapy were identified. We analysed longitudinal disease activity, assessed by the mathematically weighted Pediatric Crohn's Disease Activity Index (wPCDAI) or the physician global assessment (PGA), and adverse events (AEs).Results: Fifty-three patients with CD were included. Twelve patients received monotherapy and the others received combination treatment with thiopurines (n = 21), methotrexate (n = 11), steroids (n = 7), or exclusive enteral nutrition (n = 2). Median follow-up was 12 months (interquartile range 5-23). Remission was reached in 34 patients (64%, wPCDAI = 17.5 or decrease in PGA). Eighteen patients (34%) failed adalimumab treatment because of nonresponse (n = 4), lost response (n = 11), or AEs (n = 3). More IFX nonresponders failed adalimumab treatment than patients who lost response to IFX (2/3 vs 8/34, hazard ratio 18.8, 95% confidence interval 1.1-303.6). Only 1 patient encountered a serious AE, a severe but nonfatal infection.Conclusions: In clinical practice, adalimumab induces remission in two-thirds of children with IFX refractory CD. |
| Databáze: | OpenAIRE |
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