Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 3, May-June, p. 523–530

doi: 10.17219/acem/36417

Publication type: original article

Language: English

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Induction and Maintenance Infliximab Therapy for the Treatment of Crohn’s Disease with Perianal Fistulas in Children: Retrospective, Multicenter Study

Barbara M. Iwańczak1,A,B,C,D,E,F, Józef Ryżko2,B,C,F, Piotr Jankowski2,B,C,F, Małgorzata Sładek3,B,C,F, Agata Wasilewska3,B,C,F, Mariusz Szczepanik4,B,C,F, Edyta Sienkiewicz5,B,C,F, Anna Szaflarska-Popławska6,B,C,F, Sabina Więcek7,B,C,F, Jarosław Kwiecień8,B,C,F, Bartosz Korczowski9,B,C,F, Jolanta Maślana10,B,C,F

1 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland

2 Children’s Memorial Health Institute, Warszawa, Poland

3 Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University School of Medicine, Kraków, Poland

4 Department of Pediatric Gastroenterology and Metabolic Disorders, Poznan Univeristy of Medical Sciences, Poland

5 Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland

6 Department of Pediatrics, Allergology and Gastroenterology, L. Rydygiera Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland

7 Department of Pediatrics, Medical University of Silesia, Gastroenterology Unit, Upper-Silesian Child Health Care Center in Katowice, Poland

8 Gastroenterology Division, Department of Pediatrics, Medical University of Silesia, Zabrze, Poland

9 Department of Pediatrics, State Hospital No. 2 in Rzeszów, Poland

10 Province Children’s Hospital, Kielce, Poland

Abstract

Background. Infliximab is a biological drug used for the treatment of Crohn’s disease in children.
Objectives. The aim of this retrospective study was the estimation of effectiveness and safety of infliximab in the treatment of Crohn’s disease with perianal fistulas in children.
Material and Methods. Analysis comprised 50 children with Crohn’s disease with perianal fistulas aged 9 to 18 years (16 girls and 34 boys) who failed to respond to conventional therapy. The children were divided into two groups: the first group contained 23 children with simple fistulas and the second – 27 children with complex fistulas. All children were treated with infliximab, administered in the dose of 5 mg per kilogram of the body mass. In the induction phase infliximab was administered at weeks 0, 2 and 6 and after clinical response in maintenance phase the drug was administered every 8 weeks; together for 12 months.
Results. In 76% of children after induction therapy with infliximab and in 71.87% after maintenance therapy the complete closure of fistula occurred. During the first year after the treatment a recurrence of a fistula was observed in 30.43% of the children. In two children anaphylactic shock was observed during injection of infliximab. The remaining children tolerated the drug well.
Conclusion. The treatment with infliximab was effective in the majority of fistulazing Crohn’s disease and caused the closure of perianal fistula which improved quality of life.

Key words

Crohn’s disease, perianal fistulas, infliximab

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