Kim Jong Min, Lee Yoo Min, Kang Ben, Choe Yon Ho
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ; Department of Pediatrics, Kyung Hee University Graduate School of Medicine, Seoul, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2014 Mar;17(1):31-6. doi: 10.5223/pghn.2014.17.1.31. Epub 2014 Mar 31.
Infliximab (IFX) is considered safe and effective for the treatment of ulcerative colitis (UC) in both adults and children. The aim of this study was to evaluate the short- and long-term clinical course of IFX in Korean children with UC.
Pediatric patients with UC who had received IFX infusions between November 2007 and May 2013 at Samsung Medical Center were retrospectively investigated. The clinical efficacy of IFX treatment was evaluated at 8 weeks (short term) and 54 weeks (long term) after the initiation of IFX treatment using the Pediatric Ulcerative Colitis Activity Index (PUCAI). The degree of response to IFX treatment was defined as complete response (PUCAI score=0), partial response (decrement of PUCAI score≥20 points), and non-response (decrement of PUCAI score <20 points). Adverse events associated with IFX treatment were also investigated.
Eleven pediatric patients with moderate to severe UC had received IFX. The remission rate after IFX treatment was 46% (5/11) and 82% (9/11) at 8 weeks and 54 weeks after IFX treatment, respectively. All patients who were steroid-dependent before treatment with IFX achieved remission at 54 weeks and were able to stop treatment with corticosteroids, while all steroid-refractory patients failed to achieve remission at 54 weeks after treatment with IFX.
Response to IFX treatment after 8 weeks may predict a favorable long-term response to IFX treatment in Korean pediatric UC patients.
英夫利昔单抗（IFX）被认为对成人和儿童溃疡性结肠炎（UC）的治疗安全有效。本研究的目的是评估IFX在韩国儿童UC患者中的短期和长期临床病程。
回顾性调查2007年11月至2013年5月在三星医疗中心接受IFX输注的儿科UC患者。使用儿童溃疡性结肠炎活动指数（PUCAI）在IFX治疗开始后的8周（短期）和54周（长期）评估IFX治疗的临床疗效。对IFX治疗的反应程度定义为完全缓解（PUCAI评分为0）、部分缓解（PUCAI评分降低≥20分）和无反应（PUCAI评分降低<20分）。还调查了与IFX治疗相关的不良事件。
11例中重度UC儿科患者接受了IFX治疗。IFX治疗后8周和54周的缓解率分别为46%（5/11）和82%（9/11）。所有在接受IFX治疗前依赖类固醇的患者在54周时均实现缓解，并能够停止使用皮质类固醇治疗，而所有对类固醇难治的患者在接受IFX治疗54周后均未实现缓解。
8周后对IFX治疗的反应可能预示韩国儿科UC患者对IFX治疗有良好的长期反应。
