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Infliximab in young paediatric IBD patients: it is all about the dosing

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F20%3A10413528" target="_blank" >RIV/00216208:11130/20:10413528 - isvavai.cz</a>

  • Alternative codes found

    RIV/00064203:_____/20:10413528

  • Result on the web

    <a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=8-mmOqpTBa" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=8-mmOqpTBa</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1007/s00431-020-03750-0" target="_blank" >10.1007/s00431-020-03750-0</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Infliximab in young paediatric IBD patients: it is all about the dosing

  • Original language description

    Infliximab (IFX) is administered intravenously using weight-based dosing (5 mg/kg) in inflammatory bowel disease (IBD) patients. Our hypothesis is that especially young children need a more intensive treatment regimen than the current weight-based dose administration. We aimed to assess IFX pharmacokinetics (PK), based on existing therapeutic drug monitoring (TDM) data in IBD patients &lt; 10 years. TDM data were collected retrospectively in 14 centres. Children treated with IFX were included if IFX was started as IBD treatment at age &lt; 10 years (young patients, YP) and PK data were available. Older IBD patients aged 10-18 years were used as controls (older patients, OP). Two hundred and fifteen paediatric inflammatory bowel disease (PIBD) patients were eligible for the study (110 &lt; 10 year; 105 &gt;= 10 years). Median age was 8.3 years (IQR 6.9-8.9) in YP compared with 14.3 years (IQR 12.8-15.6) in OP at the start of IFX. At the start of maintenance treatment, 72% of YP had trough levels below therapeutic range (&lt; 5.4 μg/mL). After 1 year of scheduled IFX maintenance treatment, YP required a significantly higher dose per 8 weeks compared with OP (YP; 9.0 mg/kg (IQR 5.0-12.9) vs. OP; 5.5 mg/kg (IQR 5.0-9.3); p &lt; 0.001). The chance to develop antibodies to infliximab was relatively lower in OP than YP (0.329 (95% CI - 1.2 to - 1.01); p &lt; 0.001), while the overall duration of response to IFX was not significantly different (after 2 years 53% (n = 29) in YP vs. 58% (n = 45) in OP; p = 0.56).Conclusion: Intensification of the induction scheme is suggested for PIBD patients aged &lt; 10 years. What is Known? .Infliximab trough levels of paediatric IBD patients are influenced by several factors as dosing scheme, antibodies and inflammatory markers. .In 4.5-30% of the paediatric IBD patients, infliximab treatment was stopped within the first year. What is New? .The majority of young PIBD (&lt; 10 years) have inadequate IFX trough levels at the start of maintenance treatment. .Young PIBD patients (&lt; 10 years) were in need of a more intensive treatment regimen compared with older paediatric patients during 1 year of IFX treatment. .The chance to develop antibodies to infliximab was relatively higher in young PIBD patients (&lt; 10 years).

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30209 - Paediatrics

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2020

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    European Journal of Pediatrics

  • ISSN

    0340-6199

  • e-ISSN

  • Volume of the periodical

    179

  • Issue of the periodical within the volume

    12

  • Country of publishing house

    DE - GERMANY

  • Number of pages

    10

  • Pages from-to

    1935-1944

  • UT code for WoS article

    000560990300002

  • EID of the result in the Scopus database

    2-s2.0-85089569797