Table 2.
Studies evaluating infliximab efficacy in pediatric Crohn’s disease in the induction and maintenance phases
|
Ref.
|
Study group
|
Anti-TNF-α
|
Participants
|
Study design and aims
|
Definition of the outcome
|
Number of patients (n)
|
Age at diagnosis (yr)
|
Time
|
Clinical response
|
Clinical remission
|
| Hyams et al[16], 2007 | REACH | IFX | CD with a PCDAI > 30 | Comparison of IFX maintenance intervals; every 8 vs 12 wk. Primary responders were randomised at week 10 | Response: ∆PCDAI = -15. Remission: PCDAI ≤ 10 | Total: 103. Every 8 wk: 52. Every 10 wk: 51 | 13.3 | Week 10. Week 54 | 88.4%. Every 8 wk: 63.5%. Every 12 wk: 33.3% (P = 0.002) | 58.9%. Every 8 wk: 55.8%. Every 12 wk: 23.5% (P < 0.001) |
| Ruemmele et al[17], 2009 | GFHGNP | IFX | CD | Comparison of IFX infusion every 8 wk at maintenance vs IFX on demand. Primary responders were randomised at week 10 | Remission: Harvey Bradshaw index < 5 | Total: 40. Every 8 wk: 18. On demand: 13 | 13.9 | Week 10. Week 60 | N/A | 85%. Every 8 wk: 83%. On demand: 61% (P = 0.001) |
| Hyams et al[18], 2012 | IMAgINE | ADL | Moderate-to-severe CD | Comparison of ADL dose; HD (40 mg or 20 mg for body weight ≥ 40 kg or < 40 kg) vs LD (20 mg or 10 mg for body weight ≥ 40 kg or < 40 kg). Primary responders were randomised at week 4 | Response: ∆PCDAI = -15. Remission: PCDAI ≤ 10 | Total: 188. HD: 93. LD: 95 | HD: 13.7 ± 2.52. LD: 13.5 ± 2.47 | Week 26. Week 52 | HD: 59.1%, LD: 48.4%. HD: 41.9%, LD: 28.4% | HD: 38.7%; LD: 28.4%. HD: 33.3%; LD: 23.2% |
| Assa et al[19], 2019 | PAILOT | ADL | Biologic-naïve CD | Comparison of proactive TDM vs reactive TDM. Primary responders were randomised at week 4 | Remission: PCDAI ≤ 10 | Total: 78. Proactive: 38. Reactive: 40 | Proactive: 12.9 ± 2.6. Reactive: 13.5 ± 2.7 | Week 4. Week 72 | NA | NA. Proactive TDM: 82%; Reactive TDM: 48% |
CD: Crohn’s disease; RCT: Randomised controlled trial; IFX: Infliximab; PCDAI: Pediatric Crohn’s disease activity index; NA: Not applicable; ADL: Adalimumab; HD: High dose; LD: Low dose; TDM: Therapeutic drug monitoring.