Infliximab bests conventional treatment to achieve Crohn's disease remission in kids: BMJ

Netherlands: First-line infliximab (FL-IFX) is more effective than conventional treatment in achieving and maintaining remission in pediatric patients with newly diagnosed moderate-to-severe Crohn's disease (CD), finds a recent study in the BMJ journal Gut. Maria M E Jongsma,

In newly diagnosed paediatric patients with moderate-to-severe CD, infliximab (IFX) is initiated once exclusive enteral nutrition (EEN), corticosteroid and immunomodulator therapies have failed. Maria M E Jongsma, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands, and colleagues aimed to investigate whether starting first-line IFX (FL-IFX) is more effective to achieve and maintain remission than conventional treatment.

The multicentre open-label randomised controlled trial included 100 untreated patients with a new diagnosis of CD (3–17 years old, weighted Paediatric CD Activity Index score (wPCDAI) >40). They were assigned to groups that received five infusions of 5 mg/kg IFX at weeks 0, 2, 6, 14 and 22 (FL-IFX; n=50) or EEN or oral prednisolone (1 mg/kg, maximum 40 mg) (conventional; n=50). Four patients did not receive treatment as per protocol.