Efficacy of infliximab and adalimumab therapy in very early onset ulcerative colitis
Gastroenterology and Hepatology from Bed to Bench,
30 December 2021
Objective: Children with very early onset inflammatory bowel disease (IBD) are patients with diagnosis of IBD before 6 years of age. This multicenter study is the first one on Iranian children with very early onset ulcerative colitis (UC) and one of the few studies about the effect of biological therapy in children with UC under 7 years of age.
Method: Study was performed on 14 children under 7 years of age with severe UC. Children with severe UC who had failed therapy with corticosteroid and azathioprine as conventional treatment were treated with infliximab (IFX) and later with adalimumab (ADA).
Results: A total of 6 (43%) patients were female. The mean age was 4.9 years (3–7 years) and the mean age of diagnosis was 3.4 years (1.5–6 years). The mean duration of illness was 1.5 years. At the end of 54 weeks of therapy with IFX, 2 (14%) patients were in remission, 2 (14%) patients were mild, and 4 (29%) patients were moderate, with no secondary treatment failure (during the maintenance phase). A total of 6 (43%) patients had primary treatment failure (no response after 14 weeks of therapy). These patients had treatment with ADA. At the end of 52 weeks of therapy, out of those 6 (100%) patients, 3 (50%) patients were referred to colectomy, 1 (17%) patient had remission, and 2 (33%) patients had mild severity.
Conclusions: Our study has shown that IFX is safe and an effective therapy in children with very early onset UC. ADA may be effective in the treatment of children with UC who are refractory to IFX.
- Infliximab, adalimumab, ulcerative colitis, pediatric, inflammatory bowel disease
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