Safety and Durability of Accelerated Infliximab Dosing Strategies in Pediatric IBD: A Single Center, Retrospective Study

Author:

Gibson Meghan12,Subedi Shova12,Barker David H.3,Masur Samuel24,Mallette Meaghan M.5,Lingannan Archana12,Recinos Soto Aldo Alejandro12,Esharif Dyadin12,Maxwell Sarah H.24,Riaz Muhammad Safwan12,Herzlinger Michael I.12,Shalon Linda B.12,Cerezo Carolina S.12,Kasper Vania L.12,Ross Albert M.12,Leleiko Neal S.6,Shapiro Jason M.12

Affiliation:

1. Warren Alpert Medical School of Brown University, Providence, RI

2. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hasbro Children’s Hospital, Providence, RI

3. Department of Child and Adolescent Psychiatry, Rhode Island Hospital, Providence, RI

4. Department of Pediatrics, Hasbro Children’s Hospital, Providence, RI

5. Lifespan Biostatistics Core, Rhode Island Hospital, Providence, RI

6. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Columbia University Irving Medical Center, New York, NY.

Abstract

Objectives: Infliximab (IFX) is commonly used to treat children with inflammatory bowel disease (IBD). We previously reported that patients with extensive disease started on IFX at a dose of 10 mg/kg had greater treatment durability at year one. The aim of this follow-up study is to assess the long-term safety and durability of this dosing strategy in pediatric IBD. Methods: We performed a retrospective single-center study of pediatric IBD patients started on IFX over a 10-year period. Results: Two hundred ninety-one patients were included (mean age = 12.61, 38% female) with a follow-up range of 0.1–9.7 years from IFX induction. One hundred fifty-five (53%) were started at a dose of 10 mg/kg. Only 35 patients (12%) discontinued IFX. The median duration of treatment was 2.9 years. Patients with ulcerative colitis (P ≤ 0.01) and patients with extensive disease (P = 0.01) had lower durability, despite a higher starting dose of IFX (P = 0.03). Adverse events (AEs) were observed to occur at a rate of 234 per 1000 patient-years. Patients with a higher serum IFX trough level (≥20 µg/mL) had a higher rate of AEs (P = 0.01). Use of combination therapy had no impact on risk of AEs (P = 0.78). Conclusions: We observed an excellent IFX treatment durability, with only 12% of patients discontinuing therapy over the observed timeframe. The overall rate of AEs was low, the majority being infusion reactions and dermatologic conditions. Higher IFX dose and serum trough level> 20 µg/mL were associated with higher risk of AEs, the majority being mild and not resulting in cessation of therapy.

Publisher

Wiley

Subject

Gastroenterology,Pediatrics, Perinatology and Child Health

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3