The duration of effect of infliximab maintenance treatment in paediatric Crohn’s disease is limited
Article first published online: 14 NOV 2010
© 2010 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 33, Issue 2, pages 243–250, January 2011
How to Cite
De Bie, C. I., Hummel, T. Z., Kindermann, A., Kokke, F. T. M., Damen, G. M., Kneepkens, C. M. F., Van Rheenen, P. F., Schweizer, J. J., Hoekstra, J. H., Norbruis, O. F., Tjon a Ten, W. E., Vreugdenhil, A. C., Deckers-Kocken, J. M., Gijsbers, C. F. M., Escher, J. C. and De Ridder, L. (2011), The duration of effect of infliximab maintenance treatment in paediatric Crohn’s disease is limited. Alimentary Pharmacology & Therapeutics, 33: 243–250. doi: 10.1111/j.1365-2036.2010.04507.x
- Issue published online: 14 DEC 2010
- Article first published online: 14 NOV 2010
- Publication data Submitted 2 August 2010 First decision 1 September 2010 Resubmitted 20 October 2010 Accepted 21 October 2010 EV Pub Online 14 November 2010
Aliment Pharmacol Ther 2011; 33: 243–250
Background Infliximab is effective for induction and maintenance of remission in children with moderately to severely active Crohn’s disease (CD).
Aim To evaluate the long-term efficacy of infliximab treatment in paediatric CD.
Methods In this observational, multicentre study, all paediatric CD patients in The Netherlands treated with infliximab from October 1992 to November 2009 and with minimal follow-up of 3 months since start of infliximab, were studied.
Results One hundred and fifty-two CD patients [81M; median age at start of infliximab 15.0 years (IQR 13.1–16.4)] received a median number of 10.5 infliximab infusions (IQR 6–21). Median follow-up after start of infliximab was 25 months (IQR 13–40). Kaplan–Meier analysis showed that the cumulative probability of losing response to infliximab in patients who initially required repeated infusions was 13%, 40% and 50% after 1, 3 and 5 years, respectively. Seventy-four patients (49%) needed dose adjustments, with a median time to any adjustment of 6 months.
Conclusions Duration of effect of infliximab is limited as 50% of patients on infliximab maintenance treatment lose their therapeutic response after 5 years. Dose adjustments after start of infliximab are frequently needed to regain therapeutic benefit. These findings emphasise the need for effective, long-term treatment strategies for paediatric CD.