Analysis of the Clinical Efficacy of Infliximab in the Treatment of Steroid-Refractory Ulcerative Colitis in Children

Incidence of ulcerative colitis (UC) in children has increased worldwide.

In the current study, we summarized our clinical experience using infliximab (IFX) in the treatment of children with steroid-refractory UC.

The clinical data of 9 steroid-refractory UC patients with average age of 8 years who were treated with IFX in our hospital were analyzed.

At the end of the induction period, 6 achieved a clinically significant response. Of the 6 children, 4 had mucosal healing and 2 had endoscopic remission. At week 30, among the 6 children who achieved a clinically significant response, 3 had persistent clinical remission and mucosal healing, 1 achieved mucosal healing from endoscopic remission, 1 had mild disease, and the other child had not reached 30 weeks of treatment as of this writing. At week 54, 6 of 9 children achieved clinical remission and 5 had mucosal healing. The hemoglobin concentration in the children who achieved a clinically significant response was higher than pre-treatment and the inflammation markers were lower than pre-treatment. During IFX treatment, five children had a loss of response, three had a primary non-response, and two had a secondary non-response. The latter children achieved clinical remission with optimized treatment.

IFX is a salvage treatment option for children with moderate-to-severe steroid-refractory UC. The course of treatment and the timing of drug withdrawal warrants further study.