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P574. Change of quality of life during one year infliximab therapy course in children with inflammatory bowel disease

D. Szabo1, G. Kokonyei2, A. Arato1, A. Dezsofi1, K. Molnar1, K.E. Muller1, G. Veres1, 1Semmelweis University, 1st Department of Pediatrics, Budapest, Hungary, 2Eötvös Lóránd University, Institute of Psychology, Budapest, Hungary

Background

Quality of life is not well known in children and adolescent patients with IBD. Most publications in this field have been focused on adults. The primary aim of this study was to determine the effects of one year infliximab treatment period in paediatric patient with Crohn's disease (CD).

Methods

Our prospective study involved 51 children with conventional therapy resistant, severe CD (Mean age: 15.25 year, range: 11–18 year). IFX was given at week 0, 2 and 6, and maintenance therapy at every 8 weeks. During the infliximab courses the QoL of patients was measured by IMPACT III questionnaire at week 0, 6, 30 and 54. At the same time, the Paediatric Crohn's Disease Activity Index (PCDAI) score was determined to assess the disease severity. Moreover, some of the laboratory parameters, like serum C-reactive protein (CRP), numbers of serum thrombocyta and serum albumin were followed up. Statistical analyses were based on Friedman test, and Wilcoxon test as post-hoch analysis. Auto-regressive, cross-lagged models were used as well to assess relation between QoL and clinical parameters.

Results

The initial IMPACT-III scores (percentile-25, -50, -75 at week 0: 104, 116.5, 131) increased significantly (p < 0.001) during IFX therapy (percentile-25, -50, -75 at week 54: 123, 141, 154.3). Clinical parameter improved also, notably; PCDAI, serum CRP, serum thrombocyta, serum albumin changed significantly (p < 0.001). Autoregressive cross-lagged models of IMPACT-III and PCDAI fitted well (χ2 = 11.525, CFI = 1.0, RMSEA = 0.0). Auto-regressive regression coefficients (β value) were significant for each variable over time. Cross-relations between IMPACT-III and PCDAI over time were non-significant. The strongest cross-lagged relations were observed between IMPACT-III and serum albumin, respectively IMPACT-III and thrombocyta. However, the fit indices of these models indicated poor fit.

Conclusion

IFX treatment has beneficial clinical effect which is confirmed by decrease of PCDAI, CRP and thrombocyta levels, and increase of IMPACT-III and albumin levels. Regression analysis showed no cross lagged regression relation between IMAPCT-III and PCDAI, however, cross lagged relations between quality of life and clinical parameters needs further studies.