Lionetti P, Bronzini F, Salvestrini C, Bascietto C, Canani R Berni, Dé Angelis G L, Guariso G, Martelossi S, Papadatou B, Barabino A
Dipartimento di Pediatria, Università di Firenze-Ospedale Meyer, Florence, Italy.
Aliment Pharmacol Ther. 2003 Aug 15;18(4):425-31. doi: 10.1046/j.1365-2036.2003.01672.x.
Infliximab is an effective therapy in adult patients with refractory and fistulizing Crohn's disease. Experience in children is still limited.
: To evaluate the experience in 22 children and adolescents treated with infliximab with refractory and/or fistulizing Crohn's disease, and to compare duration of response in children between early Crohn's disease and late Crohn's disease.
The experience in 22 children and adolescents treated with a total of 73 infusions was evaluated retrospectively. Treatment indication was refractory Crohn's disease in 9/22 patients, fistulizing Crohn's disease in 7/22 patients and both these conditions in 6/22. All patients with refractory Crohn's disease had late Crohn's disease (> 1 year), whereas 6/13 patients with fistulas had early disease (< 1 year).
Mean Paediatric Crohn's Disease Activity Index (PCDAI) decreased from 41.2 to 16.2 at 4 weeks (P < 0.01), and to 15.4 at 18 weeks (P < 0.01). Mean PCDAI at 18 weeks in children with early Crohn's disease and late Crohn's disease was 5.5 and 18.1, respectively (P < 0.05). Complete closure of fistulas was obtained in 5/6 children with early Crohn's disease and in 2/7 children with late Crohn's disease. Immediate adverse reactions were observed in two children.
Infliximab is a highly effective treatment in children and adolescents with both severe refractory or fistulizing Crohn's disease. Children with early Crohn's disease have a higher chance of prolonged response to infliximab than children with late Crohn's disease.
英夫利昔单抗对成年难治性和瘘管性克罗恩病患者是一种有效的治疗方法。在儿童中的经验仍然有限。
评估22例接受英夫利昔单抗治疗的难治性和/或瘘管性克罗恩病儿童及青少年的治疗经验，并比较早期克罗恩病和晚期克罗恩病儿童的缓解持续时间。
回顾性评估22例儿童及青少年接受共73次输注的治疗经验。治疗指征为9/22例患者为难治性克罗恩病，7/22例患者为瘘管性克罗恩病，6/22例患者兼具这两种情况。所有难治性克罗恩病患者均为晚期克罗恩病（病程>1年），而6/13例有瘘管的患者为早期疾病（病程<1年）。
小儿克罗恩病活动指数（PCDAI）平均值在4周时从41.2降至16.2（P<0.01），在18周时降至15.4（P<0.01）。早期克罗恩病和晚期克罗恩病儿童在18周时的PCDAI平均值分别为5.5和18.1（P<0.05）。6例早期克罗恩病儿童中有5例瘘管完全闭合，7例晚期克罗恩病儿童中有2例瘘管完全闭合。2例儿童出现即刻不良反应。
英夫利昔单抗对患有严重难治性或瘘管性克罗恩病的儿童及青少年是一种高效的治疗方法。与晚期克罗恩病儿童相比，早期克罗恩病儿童对英夫利昔单抗有更长时间缓解反应的可能性更高。
