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P315. Infliximab therapy for pediatric inflammatory bowel disease

M. Tolín, C. Martinez, V. Luengo, C. Sanchez, G. Alvarez Calatayud, J. Morales

Hospital General Gregorio Marañon, Madrid, Spain

Aim: To describe the features and evolution of the patients treated with infliximab, and the indications for infliximab treatment

Materials and Methods: Retrospective-descriptive study of patients with inflammatory bowel disease (IBD) who received infliximab infusion in the last ten years. Data of the evolution of the disease (before and after infliximab) and the indications and adverse effects of the treatment were enrolled.

Results: 11/55 (20%) of patients received infliximab (8 Crohn's disease (CD), 3 ulcerative colitis (UC)). Infliximab was indicated in therapy-resistant perianal CD (4 patients), cortico-dependent EC (4) and CU resistant to standard immunomodulators therapy (3). The median number of infusions was 7.5 (ranging 2–30). The most frequent adverse effects were anaphylactic reactions during infusion (3 cases), anemia (2 cases) and pseudo-influenza syndrome (2 cases). The median time for clinical remission was 35 days (ranging 10–60) and for analytic normalization 16 days (ranging 4–60). One patient decided to give up the treatment. Four patients showed mild reactivation of the disease after treatment, and four needed colectomy due to treatment failure.

Conclusions: Infliximab is a monoclonal IgG antibody to tumour necrosis factor-alpha indicated for CD; but recent evidences suggest that it might also be effective for treatment of UC. In our study, infliximab was more effective in achieving improvement in perianal EC than in CU. Anaphylaxis was the most frequent adverse event but it was prevented in all the patients by using premedication (corticotherapy and antihistamines).