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英夫利昔单抗(类克)治疗儿童克罗恩病

Infliximab (REMICADE) therapy in the treatment of pediatric Crohn's disease.

作者信息

Baldassano Robert, Braegger Christian P, Escher Johanna C, DeWoody Kimberly, Hendricks David F, Keenan Gregory F, Winter Harland S

机构信息

Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104- 4399, USA.

出版信息

Am J Gastroenterol. 2003 Apr;98(4):833-8. doi: 10.1111/j.1572-0241.2003.07343.x.

Abstract

OBJECTIVE

The aim of this study was to assess the efficacy and safety of a single infusion of infliximab in the treatment of pediatric Crohn's disease (CD).

METHODS

A total of 21 pediatric CD patients were enrolled at seven study centers and randomized to receive a single infusion of infliximab 1 mg/kg (n = 6), 5 mg/kg (n = 7), or 10 mg/kg (n = 8) over at least 2 hrs at week 0 in this multicenter, open-label, dose-blinded trial. Efficacy assessments, including the Pediatric Crohn's Disease Activity Index (PCDAI), modified CDAI, C-reactive protein concentration (CRP), and erythrocyte sedimentation rate (ESR) determinations, were made at screening and at weeks 1, 2, 4, 8, and 12. Adverse events were assessed throughout study participation.

RESULTS

Improvements in the PCDAI, modified CDAI, ESR, and CRP were observed with all infliximab doses, beginning at week 1. On average, all treated patients experienced approximately 50% improvement in the PCDAI by week 2. By week 12, the PCDAI remained approximately 30% improved from baseline. During the study, all 21 patients (100%) achieved a clinical response, and 10 patients (48%) achieved clinical remission. There were no infusion reactions in any of the treatment arms.

CONCLUSIONS

The results of this trial suggest that infliximab may be safe and effective as short-term therapy of medically refractory moderate to severe CD in a pediatric population.

摘要

目的

本研究旨在评估单次输注英夫利昔单抗治疗儿童克罗恩病(CD)的疗效和安全性。

方法

在7个研究中心共纳入21例儿童CD患者,在这项多中心、开放标签、剂量盲法试验中,于第0周随机接受至少2小时的单次输注英夫利昔单抗,剂量分别为1mg/kg(n = 6)、5mg/kg(n = 7)或10mg/kg(n = 8)。在筛查时以及第1、2、4、8和12周进行疗效评估,包括儿童克罗恩病活动指数(PCDAI)、改良CDAI、C反应蛋白浓度(CRP)和红细胞沉降率(ESR)测定。在整个研究过程中评估不良事件。

结果

所有英夫利昔单抗剂量组均观察到PCDAI、改良CDAI、ESR和CRP从第1周开始改善。平均而言,所有接受治疗的患者到第2周时PCDAI改善约50%。到第12周时,PCDAI仍比基线改善约30%。在研究期间,所有21例患者(100%)均获得临床缓解,10例患者(48%)实现临床缓解。任何治疗组均未出现输注反应。

结论

该试验结果表明,英夫利昔单抗作为儿科人群中对药物难治的中度至重度CD的短期治疗可能是安全有效的。

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