Role of immunosuppressive and biologic therapy in pediatric IBD

We aimed to evaluate the role of anti-TNF-alpha therapy with infliximab and adalimumab in a cohort of pediatric patients followed by our Center from 2002 to 2012. The cohort of patients examined consisted of 40 patients: 34 with Crohn disease (85%), 5 with ulcerative colitis (12.5%), one with chroni...

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Bibliographic Details
Main Author: Nobile, Stefano <1978>
Other Authors: Campieri, Massimo
Format: Doctoral Thesis
Language:en
Published: Alma Mater Studiorum - Università di Bologna 2012
Subjects:
Online Access:http://amsdottorato.unibo.it/4833/
Description
Summary:We aimed to evaluate the role of anti-TNF-alpha therapy with infliximab and adalimumab in a cohort of pediatric patients followed by our Center from 2002 to 2012. The cohort of patients examined consisted of 40 patients: 34 with Crohn disease (85%), 5 with ulcerative colitis (12.5%), one with chronic pouchitis after IPAA for ulcerative colitis (2.5%). All patients were treated with the anti-TNF-α biologic agents infliximab and adalimumab. Thirty-six received infliximab therapy: 19/36 received only infliximab, 17/36 received infliximab and then adalimumab due to loss of response to infliximab and steroid dependency; 4 patients received only adalimumab (infliximab-naïve). Anti-TNF treatment was started before 18 years of age in 34 patients: 29 received infliximab and 5 started adalimumab during childhood. Medical charts were reviewed and safety and efficacy of anti-TNF-alpha have been determined in this population. === Nel presente studio è stato valutato il ruolo della terapia con immunosoppressori e farmaci biologici anti-TNF-alfa (infliximab e adalimumab) nel trattamento delle IBD pediatriche in una coorte di pazienti seguiti presso il Centro IBD dell'Università di Bologna dal 2002 al 2012. Il gruppo consiste di 40 pazienti: 34 con malattia di Crohn (85%), 5 con colite ulcerosa (12.5%), 1 con pouchite cronica dopo intervento di IPAA per colite ulcerosa (2.5%). Tutti i pazienti sono stati trattati con anti-TNF-alfa (infliximab-IFX e adalimumab-ADA): 19/36 solo IFX, 17/36 IFX e poi ADA per perdita di risposta e steroido-dipendenza. 4 pazienti sono stati trattati solo con ADA. La terapia con anti-TNF è stata iniziata prima dei 18 anni in 34 pazienti: 29 con IFX e 5 con ADA. E' stata condotta una analisi delle cartelle cliniche, degli esami endoscopici e di laboratorio per evidenziare l'efficacia e la sicurezza di queste terapie.