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P612 Presence and severity of ulcerations in Crohn’s disease does not contribute to response for induction therapy with infliximab in children

M. Dadalski*1, A. Wegner2, E. Szymanska3, J. Kierkus1

1Children’s Memorial Health Institute, Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Warsaw, Poland, 2The Children’s Memorial Health Institute, Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Warsaw, Poland, 3The Children’s Memorial Health Institute, Paediatrics, Warsaw, Poland

Background

Induction therapy with infliximab is efficient in approximately 80% of children with Crohn’s disease (CD). It is documented that male sex, concurrent immunomodulators, non-smoking behaviour, and luminal disease are the predictors of good infliximab response. It is questionable if presence of colonic and ileal ulcerations can contribute response for biological therapy. The aim of the study was to explore the contribution of presence and severity of ulcerations to response for induction therapy with infliximab in children.

Methods

This is a sub-analysis of CIMIT study (JPGN: May 2015 - Volume 60 - Issue 5 - p 580–585). In total, 99 patients with PCDAI > 30 pts and endoscopic evaluation (using Simple Endoscopic Score for CD (SES-CD), based on 4 endoscopic variables (ulcer size, ulcerated and affected surfaces, and stenosis) in 5 ileocolonic segments (ileum, right colon, transverse colon, left colon, and rectum), and the endoscopic parameters are scored from 0–3) performed were involved to the study and received induction therapy with infliximab 5 mg/kg at weeks 0, 2, and 6. Clinical (PCDAI score) response (decrease of PCDAI ≥ 15 AND PCDAI < 30) and remission (PCDAI < 10) were assessed at week 10. Scorings of ulcer size and ulcerated surface were used as 2 independent variables in analysis of discrimination between the group with clinical response vs no response and the group with clinical remission vs no remission.

Results

None of the analysed variables had significant effect on discrimination between group with clinical response vs no response: all partial Wilks’ Lambda > 0.99. The optimal model of discrimination had sensitivity 1.00 and specificity 0.00. None of the analysed variable had significant effect on discrimination between group with clinical remission vs no remission: all partial Wilks’ Lambda > 0.99. The optimal model of discrimination had sensitivity 1.00 and specificity 0.00.

Conclusion

Presence and severity of colonic and ileal ulcerations in CD does not contribute to response for induction therapy with infliximab in children.