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* = Presenting author

P304 Crohn Disease localization does not contribute to the course of maintenance therapy with infliximab in children.

M. Dadalski*, A. Wegner, J. Kierkus

The Children's Memorial Health Institute, Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Warsaw, Poland

Background

The primary and secondary loss of efficacy are major problems during anti TNF-alpha maintenance therapy. It's documented that complete remission, concurrent immunomodulators, are the predictors of prolonged remission. It is questionable if ileal or colonic localization can contribute the CD flare. The aim of the study was to explore the contribution of CD gut localization to the course of maintenance therapy with infliximab in children.

Methods

This is a per protocol subanalysis of CIMIT study. 77 patients with PCDAI>30 pts and endoscopic evaluation (using Simple Endoscopic Score for Crohn's Disease (SES-CD), based on 4 endoscopic variables (ulcer size, ulcerated and affected surfaces, stenosis) in 5 ileocolonic segments (ileum, right colon, transverse colon, left colon, rectum) and the endoscopic parameters are scored from 0-3) performed, who finished one year maintenance therapy with infliximab 5 mg/kg were involved to the study. Clinical (PCDAI score) remission (PCDAI<10) were assessed at Week 52. Scorings in each ileocolonic segment were used as five independent variables in analysis of discrimination between: groups with clinical remission (with or without rescue therapy n=57) vs. no remission (n=20) and groups with CD flare during maintenance therapy present (n=34) vs. absent (n=43).

Results

None of the analyzed variable had significant impact on discrimination between group with clinical remission vs. no remission - all partial Wilks' Lambda > 0,97. The optimal model of discrimination had sensivity 0,98 and specifity 0,17.

None of the analyzed variable had significant impact on discrimination between group with CD flare during maintenance therapy present vs. absent - all partial Wilks' Lambda > 0,99. The optimal model of discrimination had sensivity 0,78 and specifity 0,42.

Conclusion

Crohn Disease localization does not contribute to the course of maintenance therapy with infliximab in children.