Last Updated: 2007-04-23 (Reuters Health)

Infliximab maintenance therapy appears to achieve better results when given at intervals of 8 weeks, rather than longer, in children with Crohn's disease, researchers report in the April issue of Gastroenterology.

"Infliximab is a very effective agent in the treatment of moderate to severe Crohn's disease in children," lead researcher Dr. Jeffrey Hyams told Reuters Health. "The study suggests that an induction regimen of three doses followed by every 8-week therapy rather than every 12-week therapy is associated with better remission rates at one year."

Dr. Hyams of Connecticut Children's Medical Center, Hartford and colleagues studied 103 children who, following induction, were randomized to infliximab 5 mg/kg at 8 or 12 week intervals.

At week 54, 63.5% of those on the 8-week regimen did not need dose adjustment compared to 33.3% of patients in the 12-week group. Furthermore, 55.8% of the 8-week group were in clinical remission compared to 23.5% of those in the 12-week group.

The incidence of adverse events was higher in the 8-week group, but the incidence of serious infection was similar. The proportion of patients with infusion reactions was also similar between groups.

"As with any therapy," concluded Dr. Hyams, "the clinician and family need to weigh potential benefits and risks on an individualized basis."

In an accompanying editorial, Drs. Barbara S. Kirschner and Dezheng Huo of the University of Chicago note that the study was well documented and analyzed.

However, they conclude, "It is unclear whether earlier intervention with infliximab and maintenance with immunomodulatory agents is able to prevent the 'infliximab dependency' that is replacing corticosteroid dependency in our therapeutic repertoire."

Date Posted: May 17, 2007