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J Pediatr Gastroenterol Nutr. 2004 Aug;39(2):166-70.

Infliximab is effective in acute but not chronic childhood ulcerative colitis.

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Division of Pediatric Gastroenterology and Nutrition, Boston Floating Hospital, Tufts-New England Medical Center, Boston, Massachusetts, USA.



The authors report their experience with infliximab in pediatric patients with ulcerative colitis (UC).


Fourteen patients were reviewed. Group 1 included five patients with newly diagnosed, fulminant colitis refractory to 7 to 10 days of intravenous steroids. Group 2 included four patients with ulcerative colitis in remission off steroid therapy who experienced relapse and were hospitalized with fulminant colitis refractory to intravenous steroids for 7 to 10 days. Group 3 included five patients chronically dependent on steroids with colitis refractory to medical management. All patients were treated on an open-label basis with infliximab infusions of 5 mg/kg/dose at 0, 2, and 6 weeks and every 6 to 8 weeks thereafter. Follow-up was maintained for at least 6 weeks. Clinical status was scored with the Lichtiger Colitis Activity Index (LCAI) at each visit. LCAI >or=10 was considered treatment failure. We defined success as LCAI <or=2, a score consistent with UC remission. Response was categorized for each group.


All patients began the study with LCAI >or=11 before infliximab treatment. All group 1 patients experienced response to infliximab. All but one (75%) patient in group 2 had a response. Only one (20%) group 3 patient had a response to infliximab.


Infliximab was an effective agent in the treatment of acute UC in our patients. Long-term steroid use and emergency colectomy were avoided. Infliximab was less effective in patients who were dependent on steroids.

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