First-line Remicade Effective in Children with Crohn’s

First-line Remicade Effective in Children with Crohn’s

A new study reveals that first-line Remicade therapy provided superior results compared to conventional treatments in achieving short-term remission in children with Crohn’s disease.

In a recent article by Healio, Lissy de Ridder, MD, Ph.D., from the gastroenterology department at Erasmus MC Sophia Children Hospital in the Netherlands, and her colleagues stated that Remicade (infliximab, Janssen) is usually only started in children with CD if conventional treatments are ineffective.

However, as Ridder and her team mentioned, many pediatric patients with Crohn’s disease (CD), especially those with moderate to severe CD, don’t achieve mucosal healing and sustained clinical remission with conventional treatment.

“First-line infliximab is mentioned in the current pediatric CD treatment guidelines as the preferred strategy only for patients with CD with active perianal fistulizing disease and those at risk of disabling disease.”

For this new study, researchers conducted an open-label, randomized controlled trial comprising 100 patients. The study aimed to determine if starting infliximab as a first-line treatment is more effective than conventional therapies.

The research study included patients between the ages of 3 and 17 with a new diagnosis of Crohn’s disease. Investigators assigned the patients to groups that received five infusions of infliximab or oral prednisone, or exclusive enteral nutrition (conventional treatments).

The principal outcome was clinical remission on azathioprine, defined as a weighted Pediatric Crohn’s disease Activity Index (wPCDAI) score less than 12.5 at week 52 without further treatment escalation needed.

Study results show that by week 10, a higher percentage of patients in the infliximab group achieved clinical (59% vs. 34%, P= .021) and endoscopic remission (59% vs. 17%, P = .001) when compared to the conventional therapy group.

First-line Remicade Effective in Children with Crohn’s

Although the groups had similar proportions of patients in clinical remission by week 52, it’s worth noting that 41% of patients in the infliximab group achieved clinical remission on azathioprine monotherapy without the need for escalation compared with only 15% of patients in the conventional therapy group (P = .004).

De Rider commented:

“Despite the similar clinical remission rates at one year after diagnosis in both treatment groups, we argue that children and adolescents with moderate-to-severe CD would benefit from first-line infliximab treatment as an insufficiently effective treatment strategy impacts their growth and development.”

Furthermore, De Rider stated:

“This innovative treatment was well accepted by children and their parents, which shows the importance of moving forward with protocols to allow us to learn what is best.


At Altus Biologics, we support researchers’ efforts to find more effective treatments for Crohn’s disease and other chronic illnesses through the use of innovative infusion drug treatments.

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