TAILIEUCHUNG - Infliximab therapy in pediatric Crohn’s disease: a review

The complexity of children’s environmental health (CEH) issues is compounded by the combination of legacy environmental issues, such as water quality and sanitation service delivery, with modern challenges such as transboundary contamination by persistent toxic substances, ozone depletion and hence ultraviolet and ionising radiation, global climate change, and exposure to endocrine-disrupting chemicals). For children in developing countries, the presence of all such risks represent a ‘triple burden of disease’ – a high level of communicable diseases, the increasingly severe burden of non-communicable diseases, and emerging risks from new diseases and additional stressors from the social and physical environment. . | Clinical and Experimental Gastroenterology Q Open Access Full Text Article Dovepress open access to scientific and medical research REVI EW Infliximab therapy in pediatric Crohn s disease a review This article was published in the following Dove Press journal Clinical and Experimental Gastroenterology 11 June 2010 Number of times this article has been viewed Kalyan Ray Parashette1 Raghavendra Charan Makam2 Carmen Cuffari3 Abstract Anti-tumor necrosis factor alpha TNF-a therapy has re-defined our treatment paradigms in managing patients with Crohn s disease CD and ulcerative colitis. Although the ACCENT studies showed proven efficacy in the induction and maintenance of disease remission in adult patients with moderate to severe CD the pediatric experience was instrumental in bringing forth the notion of top-down therapy to improve overall clinical 1Department of Pediatrics University of Illinois at Chicago Chicago IL USA 2Department of Internal Medicine Berkshire Medical Center Pittsfield MA USA 3Division of Pediatric Gastroenterology The Johns Hopkins Children s Center Baltimore MD USA response while reducing the risk of complications resulting from long-standing active disease. Infliximab has proven efficacy in the induction and maintenance of disease remission in children and adolescents with CD. In an open-labeled study of 112 pediatric patients with moderate to severe CD 58 achieved clinical remission on induction of infliximab 5 mg kg therapy. Among those patients who achieved disease remission 56 maintained disease remission on maintenance 5 mg kg every 8 weeks therapy. Longitudinal follow-up studies have also shown that responsiveness to infliximab therapy also correlates well with reduced rates of hospitalization and surgery for complication of long-standing active disease including stricture and fistulae formation. Moreover these children have also been shown to improve overall growth while maintaining an effective disease remission. The pediatric .

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