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- W2103107661 abstract "Background: The adalimumab (ADA) treatment is an available option for pediatric CD. The published experience on ADA treatment in pediatric Crohn's disease (CD) is limited. Objectives: We reported a multicenter evaluation of the Italian Society of Pediatric Gastroenterology Hepatology and Nutrition about ADA efficacy and safety after IFX failure in pediatric CD. Methods: A retrospective study recorded demographic data, growth parameters, clinical response (PCDAI score), endoscopic findings (CDEIS score) and adverse events at 6 m and at the patient's last follow up. Results: 42 pts were evaluated at the ADA start, after IFX therapy. The main characteristics were: mean age 14.6 y, 22 F, 75% moderate-severe disease (mean PCDAI 25). 52% CRP value positive; mean time from diagnosis 3.8 y (range 5 m–11 y). Only one needed steroids. At 6 m 61% complete clinical remission, 13% partial clinical remission 26% active disease (mean PCDAI 12). 42% had CRP positive values. Mean follow up time after ADA start was 14 m. At the last follow up: At maximum follow up, 62% of pts were in clinical remission, 6% in partial clinical remission and 32% pts had active disease. The mean PCDAI value at the ADA start was 24.5 (median 23.7), at 6 months was 12.8 (median 10) and at the last follow up 13.7 (median 10). PCDAI decrements were statistically significant (p < 0.01). At maximum follow up 42% of pts CRP values were positive. At last follow up endoscopic evaluation was available in 54% of pts and documented mucosal healing in 65%, mild-moderate lesions in 10% and severe lesions in 25%. Not significant difference in statural growth and weight gain was detected from the ADA start. Adverse events were one case of meningitis and one of medulloblastoma treated with IFX and ADA (18 m). In univariate analysis no prognostic factors were found (sex, age and disease extension, reasons for IFX stop) except for the combined therapy IFX and immunomodulators and disease duration > 3 y before ADA start that were negatively correlated with the final PCDAI values (p < 0.01). Conclusions: In our experience, ADA therapy has been a good alternative, when IFX did not work, in determining clinical and endoscopic remission (65% of pts). Treatment efficacy with anti-TNF agents should be balanced against infection risk and possible onset of cancer." @default.
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- W2103107661 date "2013-09-01" @default.
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- W2103107661 title "Evaluation of adalimumab (ADA) therapy after infliximab (IFX) failure in pediatric Crohn disease (CD)" @default.
- W2103107661 doi "https://doi.org/10.1016/j.dld.2013.08.147" @default.
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