Infliximab (REMICADE) therapy in the treatment of pediatric Crohn's disease

Infliximab (REMICADE) therapy in the treatment of pediatric Crohn's disease
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DOI:
10.1016/s0002-9270(03)00007-8
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发表时间:
2003-04-01
影响因子:
9.8
通讯作者:
Winter, HS
Winter, HS
中科院分区:
医学1区
文献类型:
--
作者:
Baldassano, R;Braegger, CP;Winter, HS

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目的:本研究的目的是评估单次输注英夫利西单抗治疗小儿克罗恩病(CD)的疗效和安全性。共有21名儿童CD患者在7个研究中心入组,并随机接受英夫利西单抗1 mg/kg(n = 6)、5 mg/kg(n = 7)、或10 mg/kg(n = 8),在该多中心、开放标签、剂量设盲试验中,在第0周至少给药2小时。在筛选时和第1、2、4、8周进行疗效评估,包括儿童克罗恩病活动指数(PCDAI)、改良CDAI、C反应蛋白浓度(CRP)和红细胞沉降率(ESR)测定。和12.不良事件进行了评估整个研究participation.Results:改善PCDAI,修改CDAI,ESR和CRP观察所有英夫利西单抗剂量,开始,在第1周。平均而言,所有接受治疗的患者在第2周时PCDAI改善约50%。到第12周,PCDAI较基线改善约30%。研究期间,所有21例患者(100%)均达到临床应答,10例患者(48%)达到临床缓解。有没有输液反应,在任何治疗arms.CONCLUSIONS:这项试验的结果表明,英夫利西单抗可能是安全和有效的短期治疗医学难治性中度至重度CD在儿科人群。
OBJECTIVES: The aim of this study was to assess the efficacy and safety of a single infusion of infliximab in the treatment of pediatric Crohn's disease (CD).METHODS: A total of 21 pediatric CD patients were enrolled at seven study centers and randomized to receive a single infusion of infliximab 1 mg/kg (n = 6), 5 mg/kg (n = 7), or 10 mg/kg (n = 8) over at least 2 hrs at week 0 in this multicenter, open-label, dose-blinded trial. Efficacy assessments, including the Pediatric Crohn's Disease Activity Index (PCDAI), modified CDAI, C-reactive protein concentration (CRP), and erythrocyte sedimentation rate (ESR) determinations, were made at screening and at weeks 1, 2, 4, 8. and 12. Adverse events were assessed throughout study participation.RESULTS: Improvements in the PCDAI, modified CDAI, ESR, and CRP were observed with all infliximab doses, beginning, at week 1. On average, all treated patients experienced approximately 50% improvement in the PCDAI by week 2. By week 12, the PCDAI remained approximately 30% improved from baseline. During the study, all 21 patients (100%) achieved a clinical response, and 10 patients (48%) achieved clinical remission. There were no infusion reactions in any of the treatment arms.CONCLUSIONS: The results of this trial suggest that infliximab may be safe and effective as short-term therapy of medically refractory moderate to severe CD in a pediatric population.