Combination biologic therapy in pediatric inflammatory bowel disease: Safety and efficacy over a minimum 12‐month follow‐up period

医学 维多利祖马布 英夫利昔单抗 阿达木单抗 四分位间距 溃疡性结肠炎 炎症性肠病 乌斯特基努马 粪钙保护素 胃肠病学 钙蛋白酶 回顾性队列研究 克罗恩病 疾病 内科学
作者
Magdalena Wlazło,Monika Meglicka,Anna Wiernicka,Marcin Osiecki,Małgorzata Matuszczyk,Jarosław Kierkuś
出处
期刊:Journal of Pediatric Gastroenterology and Nutrition [Lippincott Williams & Wilkins]
卷期号:79 (1): 54-61 被引量:1
标识
DOI:10.1002/jpn3.12179
摘要

Abstract Objectives The severe course of inflammatory bowel diseases (IBDs) refractory to advanced therapies in children results in the search for new therapeutic methods. The aim of this study was to evaluate the efficacy and safety of dual therapy with biologics in a cohort of children with IBD. Methods Retrospective analysis of data from 29 children with a diagnosis of IBD, 19 with ulcerative colitis (66%), 10 with Crohn's disease (CD) (34%) qualified for dual biological therapy (DBT). The median age of patients was five (interquartile range [IQR], 1–15) years at diagnosis of IBD and 14 (IQR, 3–17) years at eligibility for dual therapy. Thirteen (45%) patients were treated with vedolizumab/adalimumab (VDZ + ADA), 13 (45%) with ustekinumab/adalimumab (UST + ADA), three (10%) with infliximab/vedolizumab (IFX + VDZ). Results Clinical remission was achieved in 13 (45%; seven UC and six CD) and 12 (41%; seven UC and five CD) Pediatric Weighted Crohn's Disease Activity Index (wPCDAI)/Pediatric Ulcerative Colitis Activity Index (PUCAI) patients after 4 and 12 months at the initiation of dual therapy. Clinical response based on wPCDAI/PUCAI was reported in 16 (55%; nine UC and seven CD) and 12 (41% seven UC and five CD) children after 4 and 12 months of follow‐up, respectively. The median fecal calprotectin decreased significantly from 1240 µg/g (53–10,100) to 160 µg/g (5–2500; p = 0.004) between baseline and Month 4 and from 749 at baseline (57–10,100) to 17 (5–3110; p = 0.12) over 12 months. Moreover, 34% (six UC and four CD) of patients achieved endoscopic remission. Conclusions DBT seems to be an effective alternative therapeutic option for patients with moderate and severe IBD.
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