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Published in: Drugs 12/2007

01-08-2007 | Review Article

Infliximab Therapy in Children and Adolescents with Inflammatory Bowel Disease

Authors: Gabor Veres, Dr Robert N. Baldassano, Petar Mamula

Published in: Drugs | Issue 12/2007

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Abstract

This review summarises the present knowledge of infliximab therapy in children with inflammatory bowel disease (IBD) based on the available published literature.
Infliximab, the chimeric monoclonal IgG1 antibody to tumour necrosis factor-α, is indicated for medically refractory luminal and fistulising paediatric Crohn’s disease. Recently, ulcerative colitis case series in children and adolescents suggested that infliximab might also be effective for treatment of ulcerative colitis resistant to standard medical therapy.
Induction therapy with infliximab 5 mg/kg at weeks 0, 2 and 6 is routinely used. Since the majority of patients will relapse if not re-treated, a long-term approach with systematic re-treatment with 5 mg/kg every 8–12 weeks is recommended. Maintenance therapy every 8 weeks was superior to 12 weeks’ administration in maintaining response and remission in the largest-to-date paediatric randomised trial. Concomitant immunosuppressive therapy reduces the risk of infliximab antibody formation and infusion reactions, and prolongs the duration of treatment success. Severe reactions may not be an absolute contraindication to future infliximab therapy. Premedication does not prevent the development of infusion reactions; however, it is indicated for prevention of subsequent infusion reactions. Adverse events and safety findings in children are comparable to those observed in adults. Latent tuberculosis needs to be screened for. Malignancy rates in paediatric patients treated with infliximab do not seem to be increased. However, newly reported cases of hepatosplenic T-cell lymphoma in young patients with IBD treated with infliximab and mercaptopurine therapy raise concern, and long-term follow-up studies are necessary to determine the true malignancy risk.
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Metadata
Title
Infliximab Therapy in Children and Adolescents with Inflammatory Bowel Disease
Authors
Gabor Veres
Dr Robert N. Baldassano
Petar Mamula
Publication date
01-08-2007
Publisher
Springer International Publishing
Published in
Drugs / Issue 12/2007
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200767120-00005

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