scholarly journals Infliximab treatment time and the mucosal healing effect in pediatric patients with severe Crohn’s disease – own experience

2012 ◽  
Vol 2 ◽  
pp. 87-93 ◽  
Author(s):  
Grażyna Czaja-Bulsa ◽  
Aneta Gębala ◽  
Anna Korlatowicz-Bilar
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pediatric Patients ◽  
Treatment Time ◽  
Mucosal Healing ◽  
Infliximab Treatment ◽  
Healing Effect

Infliximab plus azathioprine is more effective than azathioprine alone in achieving mucosal healing in pediatric patients with Crohn's disease

2020 ◽  
Vol 21 (12) ◽  
pp. 705-710
Author(s):  
Jan Melek ◽  
Markéta Štanclová ◽  
Petr Dědek ◽  
Jan Malý ◽  
Milan Bayer ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pediatric Patients ◽  
Mucosal Healing

scholarly journals The Association Between Genetic Variants, Pharmacokinetics, and Infliximab Efficacy in Pediatric Patients With Crohn's Disease in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Wenhui Hu ◽  
Yan Feng ◽  
Ziqing Ye ◽  
Zifei Tang ◽  
Lai Qian ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Genetic Variants ◽  
Pediatric Patients ◽  
Activity Index ◽  
Area Under The Curve ◽  
Disease Activity Index ◽  
Threshold Level ◽  
Mucosal Healing ◽  
Nucleotide Polymorphisms

Background: Infliximab is an effective therapy for Crohn's disease (CD). Early non-invasive predictors of disease remission allow for modification of treatments. The aim of this study was to investigate the associations between genetic variants, pharmacokinetics, and infliximab efficacy in pediatric patients with CD.Methods: This retrospective observational study included CD patients under infliximab therapy between August 2015 and December 2020. Information on demographics, laboratory tests, medication data, and disease activity index was collected. The trough levels of infliximab (TLI) and antibodies to infliximab (ATI) were measured at week 14, and reactive drug monitoring was performed during follow-up. Ten single-nucleotide polymorphisms involved in the NF-κB-mediated inflammatory response, pharmacokinetics, and therapeutic response to infliximab were genotyped.Results: A total of 62 pediatric CD patients were enrolled. The clinical remission (CR) rate was 69.4 and 63.2% at week 14 and week 30, respectively. TLI at week 14 was significantly independently associated with CR at week 14 and mucosal healing (MH) at week 30 (p = 0.007 and p = 0.025, respectively). The optimal TLI threshold level capable of distinguishing between the CR and non-CR groups was 2.62 μg/ml (p < 0.001, area under the curve = 0.79, sensitivity = 69.2%, specificity = 78.9%), while that capable of distinguishing between the MH and non-MH groups was 3.34 μg/ml (p < 0.001, area under the curve = 0.85, sensitivity = 78.6%, specificity = 79.4%). Rs3397 in TNFRSF1B was associated with time to ATI production in CD patients (p < 0.001).Conclusions: Higher TLI contributed to achieving MH. Genotyping rs3397 in TNFRSF1B may identify patients who are prone to generating immunogenicity to drugs.

scholarly journals Efficacy of infliximab treatment on the mucosal healing of different intestinal segments in patients with ileocolonic Crohn’s disease

2020 ◽  
Vol 13 ◽  
pp. 175628482097692
Author(s):  
Yaling Wu ◽  
Lei Zhang ◽  
Jingli Cao ◽  
Haichao Wang ◽  
Chen Ye ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Transverse Colon ◽  
Mucosal Healing ◽  
Treat To Target ◽  
Infliximab Treatment ◽  
Right Colon ◽  
Single Center Study ◽  
The Right

Background: Mucosal healing (MH) is the key aim of the treat-to-target strategy for patients with Crohn’s disease (CD). The efficacy of infliximab (IFX) on MH in different ileocolonic segments is unclear. The aim of this study was to investigate endoscopic MH in different ileocolonic segments in patients with CD who received IFX treatment. Methods: A retrospective, single-center study was performed in patients with active ileocolonic CD between January 2012 and December 2018. All patients underwent IFX treatment for at least 30 weeks. The MH of five ileocolonic segments was assessed by the Simple Endoscopic Score for CD (SES-CD) at baseline, 14/22 weeks and 30/38 weeks. The SES-CD values were analyzed by a mixed-effects model after the correction for confounding factors. Results: A total of 101 eligible patients were included. The baseline endoscopic severity was similar across segments. At 30/38 weeks, the greatest changes in the SES-CD ulcer size and ulcerated surface subscores were −94.29% and −94.32% both in the transverse colon ( p < 0.0001), and the smallest changes were −67.88% and −69.67% both in the terminal ileum ( p < 0.0001) compared with baseline. Stenosis mainly presented in the right colon (12/29, 41.38%). The change in the SES-CD stenosis subscore was −6.25% in the right colon at 30/38 weeks compared with −71.88% at 14/22 weeks ( p = 0.0030). At 30/38 weeks, the transverse colon achieved the highest rate of complete MH (CMH) at 81.2%, and the lowest CMH rate occurred in the terminal ileum at 45.6%. Moreover, the degree of improvement in the rectum was negatively correlated with disease progression ( p = 0.011). Conclusions: Ileocolonic segments in CD presented different degrees of endoscopic MH during IFX treatment. The transverse colon showed the highest CMH rate, whereas the right colon with stenosis showed the poorest improvement. The differing propensities of ileocolonic segments may provide an individualized IFX treatment strategy.

Visceral Fat Is Associated With Mucosal Healing of Infliximab Treatment in Crohn’s Disease

2018 ◽  
Vol 61 (6) ◽  
pp. 706-712 ◽  
Author(s):  
Weisong Shen ◽  
Lei Cao ◽  
Yi Li ◽  
Xingchen Cai ◽  
Yuanyuan Ge ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Visceral Fat ◽  
Mucosal Healing ◽  
Infliximab Treatment

scholarly journals Mucosal healing is not associated with better outcome during seven years of follow-up in pediatric patients with Crohn's disease

2020 ◽  
Author(s):  
Jan Melek ◽  
Markéta Štanclová ◽  
Petr Dědek ◽  
Radek Štichhauer ◽  
Jaroslav Koudelka ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pediatric Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Mucosal Healing ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact

Abstract Background Mucosal healing (MH) has become a perspective treatment target in patients with Crohn’s disease (CD). Data about the impact of MH on long-term outcome in pediatric patients are still scarce. Methods 76 pediatric patients with CD were evaluated retrospectively (2000–2015) in a tertiary care center. Based on MH achievement, they were divided into two groups (MH, n = 17 and No MH, n = 59). The primary endpoint was to assess the association of MH and the need for CD-related hospitalizations or surgery in pediatric patients with CD. Results The number of hospitalized patients was 24% in the MH group and 42% in the No MH group, P = 0.26. The total number of CD-related hospitalizations was not significant between the MH group and the No MH group (5 vs. 41, P = 0.15). The time to the first hospitalization was 24 months in MH and 21 months in No MH, p > 0.99. 24% patients in the MH group and 39% patients in the No MH group underwent CD-related operation, P = 0.39. Time to the first operation was 43 months for MH and 19 months for the No MH group, P = 0.13. The follow-up period was 91 months in the MH group and 80 months in the No MH group, P = 0.74. The use of infliximab was positively associated with MH, P = 0.002. Conclusions MH was not associated with fewer CD-related hospitalizations or operations in pediatric patients with CD during seven years of follow-up.

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