A recent study entitled “Infliximab therapy in pediatric patients 7 years of age and younger” reports that infliximab therapy is less efficient in treating inflammatory bowel disease in children aged less than 7 years old when compared to its effect in older children. The study was published in the Journal of Pediatric Gastroenterology & Nutrition.
Inflammatory bowel disease consists of a group of autoimmune diseases characterized by dysregulated immune response against the colon and small intestine. The two main types of inflammatory bowel disease are ulcerative colitis and Crohn’s disease, with the first being limited to the colon while Crohn’s disease can affect the entire gastrointestinal tract (from mouth to anus).
Inflammatory bowel disease is estimated to affect approximately 1 million Americans, and usually occurs in young people (from 10 years old to older age). However, young children (less than 7 years old) have also been reported to suffer from inflammatory bowel disease. Since therapeutics for inflammatory bowel disease are usually tested in older children, in this study the authors tested whether infliximab therapy, which is capable of maintaining disease remission in young children with mild or severe inflammatory bowel disease, is equally effective when administered to children who are less than 7 years old.
To this end, the authors performed a retrospective study of IBD-affected children less than 7 years old who were administered with infliximab therapy for approximately 12 years (from 1999 and 2011). The authors reviewed medical records during the period of treatment and registered all outcomes, including adverse events and if additional corticosteroid therapy was required. From the pooled studies, they analysed the cases for thirty-three children with ages between 2 and 7 years old and who were diagnosed with either Crohn’s disease (20 children), ulcerative colitis (4 children) and indeterminate colitis (9 children). The authors observed that only 25% of the children aged 5 years or younger maintained infliximab therapy administration during the first year, and this number decreased to 10% at year two and three. Only 9% of all administered patients registered a positive response and were free of another steroid therapy during the first year.
Thus, the authors concluded that infliximab therapy did not prove to be an efficacious treatment for children with IBD 7 years old and younger.
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