Efficacy of switching from infliximab to adalimumab in children with inflammatory bowel disease
10.3760/cma.j.cn101480.20231116.00064
- VernacularTitle:英夫利西单克隆抗体转换阿达木单克隆抗体治疗儿童炎症性肠病的疗效探讨
- Author:
Youhong FANG
1
;
Youyou LUO
1
;
Jie CHEN
1
Author Information
1. 浙江大学医学院附属儿童医院消化科 国家儿童健康与疾病临床医学研究中心，杭州 310052
- Publication Type:Journal Article
- Keywords:
Inflammatory bowel disease;
Adalimumab;
Infliximab;
Efficacy;
Child
- From:
Chinese Journal of Inflammatory Bowel Diseases
2024;08(6):424-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of switching to adalimumab (ADA) treatment in pediatric with inflammatory bowel disease (IBD) after failure of infliximab (IFX) treatment.Methods:Clinical data of children with IBD who were treated at the Children's Hospital of Zhejiang University School of Medicine from January 2019 to May 2023 and switched to ADA treatment after IFX treatment failure were retrospectively included. The clinical symptoms, laboratory results, disease activity index of pediatrics, and endoscopic severity scores under colonoscopy were compared between baseline, treatment after 3 months and 12 months.Results:A total of 47 IBD patients were enrolled, including 36 cases of Crohn's disease, 4 cases of ulcerative colitis, and 7 cases of IBD unclassified. There were 28 male and 19 female patients. Among patients who were converted to ADA treatment, 31/47 (66.0%) had low trough concentration and high anti-IFX antibodies, 12/47 (25.5%) had allergic reactions to IFX, and 4/47 (8.5%) had low IFX trough concentration and no anti-IFX antibody. The overall 12 month retention rate of IBD patients who converted to ADA treatment after IFX treatment was 76.6% (36/47). After 3 months of ADA treatment, compared to the baseline, in body mass index for age, height for age, and serum albumin levels increased, while inflammatory markers such as high sensitivity C reactive protein, erythrocyte sedimentation rate, and pediatric Crohn's disease activity index scores decreased. Compared to 3 months of treatment, nutritional and inflammatory markers after 12 months of treatment were stable. No serious adverse reactions or severe infections were found. Six (13%) patients who had pain and swelling at the injection site. Two patients were detected to have high titers of antibodies.Conclusions:Pediatric IBD patients switched to ADA treatment after failure of IFX treatment with ADA for 3 months improves nutrition status and serum albumin levels, while reducing inflammatory markers and disease activity. No serious adverse reactions are found. Application of ADA after failure of IFX treatment provides a practical basis for converting biological agents for pediatric IBD.
