Background: Biological treatment, especially with anti TNF agents, has become standard of care in pediatric IBD. Nevertheless, there are no clear guidelines how long biologic treatment should be continued.
The study retrospectively investigated the efficacy and safety of an infliximab protocol that consisted of 3 induction doses and 3 maintenance doses as long as the patient was in remission at the 6th dose.
Materials and methods: the study reviewed the charts of 46 children with the diagnosis of IBD who mostly received infliximab infusion according to the specified protocol. The primary end point was the ability to maintain remission after 6 doses and the secondary was the induction of remission after reintroducing infliximab for those who relapsed. Remission was defined as normal laboratory tests and normal clinical scores (PUCAI/PCDAI).
Results: Under this protocol of infliximab treatment; 3 induction doses and 3 maintenance doses, 76.5% and 70% of the children with CD and UC, respectively, underwent into remission. The median infliximab doses for achieving and maintaining remission was 6.5 and 7 for Crohn disease and ulcerative colitis respectively. The length of remission varied between patients; 3-72 months (mean 20.8±19.1 months), while the majority maintained remission for over 12 months. For those who relapsed and were reintroduced to infliximab infusions (10 patients), 3 (30%) achieved remission.
Conclusions: infliximab is a successful and a safe treatment for induction and maintenance of remission in pediatric IBD patients. The suggested protocol has been proven to be efficient and safe in the majority of the children.
