PMID- 25286063
OWN - NLM
STAT- MEDLINE
DCOM- 20151110
LR  - 20220331
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Linking)
VI  - 60
IP  - 2
DP  - 2015 Feb
TI  - Adalimumab therapy in children with Crohn disease previously treated with 
      infliximab.
PG  - 205-10
LID - 10.1097/MPG.0000000000000589 [doi]
AB  - OBJECTIVES: Adalimumab, a humanised anti-tumour necrosis factor antibody, is an 
      effective treatment in adult patients with refractory Crohn disease (CD). The 
      available literature on its efficacy in children remains limited. We aimed to 
      evaluate the real-world efficacy in paediatric patients with CD and compare the 
      efficacy between infliximab (IFX) nonresponders and patients who lost response to 
      IFX. METHODS: All Dutch patients with CD receiving adalimumab before the age of 
      18 years after previous IFX therapy were identified. We analysed longitudinal 
      disease activity, assessed by the mathematically weighted Pediatric Crohn's 
      Disease Activity Index (wPCDAI) or the physician global assessment (PGA), and 
      adverse events (AEs). RESULTS: Fifty-three patients with CD were included. Twelve 
      patients received monotherapy and the others received combination treatment with 
      thiopurines (n = 21), methotrexate (n = 11), steroids (n = 7), or exclusive 
      enteral nutrition (n = 2). Median follow-up was 12 months (interquartile range 
      5-23). Remission was reached in 34 patients (64%, wPCDAI < 12.5 or PGA = 0) after 
      a median of 3.3 months, and maintained by 50% for 2 years. Eleven patients (21%) 
      reached response but not remission (decrease in wPCDAI >/= 17.5 or decrease in 
      PGA). Eighteen patients (34%) failed adalimumab treatment because of nonresponse 
      (n = 4), lost response (n = 11), or AEs (n = 3). More IFX nonresponders failed 
      adalimumab treatment than patients who lost response to IFX (2/3 vs 8/34, hazard 
      ratio 18.8, 95% confidence interval 1.1-303.6). Only 1 patient encountered a 
      serious AE, a severe but nonfatal infection. CONCLUSIONS: In clinical practice, 
      adalimumab induces remission in two-thirds of children with IFX refractory CD.
FAU - Cozijnsen, Martinus
AU  - Cozijnsen M
AD  - *Pediatric Gastroenterology, Erasmus Medical Center-Sophia Children's Hospital, 
      Rotterdam daggerPediatric Gastroenterology, Radboud University Nijmegen Medical 
      Centre, Nijmegen double daggerPediatric Gastroenterology, Wilhelmina Children's 
      Hospital-University Medical Center, Utrecht  section signPediatric Gastroenterology, Emma 
      Children's Hospital-Academic Medical Center, Amsterdam ||Pediatric 
      Gastroenterology, Beatrix Children's Hospital-University Medical Center 
      Groningen, Groningen  paragraph signPediatric Gastroenterology, VU University Medical Center, 
      Amsterdam #Pediatric Gastroenterology, Willem-Alexander Kinderziekenhuis-Leiden 
      University Medical Center, Leiden **Pediatric Gastroenterology, Isala Hospital, 
      Zwolle daggerdaggerPediatric Gastroenterology, Catharina Hospital, Eindhoven double daggerdouble daggerPediatric 
      Gastroenterology, Maastricht University Medical Center, Maastricht  section sign section signPediatric 
      Gastroenterology, Amphia Hospital, Breda ||||Pediatric Gastroenterology, Medisch 
      Spectrum Twente, Enschede  paragraph sign paragraph signPediatric Gastroenterology, Gelre Hospitals, 
      Apeldoorn, The Netherlands.
FAU - Duif, Vera
AU  - Duif V
FAU - Kokke, Freddy
AU  - Kokke F
FAU - Kindermann, Angelika
AU  - Kindermann A
FAU - van Rheenen, Patrick
AU  - van Rheenen P
FAU - de Meij, Tim
AU  - de Meij T
FAU - Schaart, Maaike
AU  - Schaart M
FAU - Damen, Gerard
AU  - Damen G
FAU - Norbruis, Obbe
AU  - Norbruis O
FAU - Pelleboer, Rolf
AU  - Pelleboer R
FAU - Van den Neucker, Anita
AU  - Van den Neucker A
FAU - van Wering, Herbert
AU  - van Wering H
FAU - Hummel, Thalia
AU  - Hummel T
FAU - Oudshoorn, Johanna
AU  - Oudshoorn J
FAU - Escher, Johanna
AU  - Escher J
FAU - de Ridder, Lissy
AU  - de Ridder L
CN  - Dutch PIBD Working Group Kids with Crohn and Colitis
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
SB  - IM
MH  - Adalimumab
MH  - Adolescent
MH  - Anti-Inflammatory Agents, Non-Steroidal/adverse effects/*therapeutic use
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized/adverse effects/*therapeutic use
MH  - Child
MH  - Crohn Disease/*drug therapy
MH  - Drug Resistance
MH  - Drug Therapy, Combination
MH  - Drug Tolerance
MH  - Female
MH  - Humans
MH  - Infliximab
MH  - Male
MH  - Retreatment
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Failure
EDAT- 2014/10/07 06:00
MHDA- 2015/11/11 06:00
CRDT- 2014/10/07 06:00
PHST- 2014/10/07 06:00 [entrez]
PHST- 2014/10/07 06:00 [pubmed]
PHST- 2015/11/11 06:00 [medline]
AID - 10.1097/MPG.0000000000000589 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2015 Feb;60(2):205-10. doi: 
      10.1097/MPG.0000000000000589.