Infliximab Therapy in Very Early Onset Crohn’s Disease: Real-World Experience in China

Background Data concerning of the effectiveness of infliximab in very early onset Crohn’s disease patients are rare. Aim To assess the effectiveness and safety issues of infliximab treatment for this rare cohort. Methods The pediatric Crohn’s disease activity index, Crohn’s disease endoscopic index score, height, and weight were retrospectively recorded at baseline, week 14, and week 54. The rates of clinical remission and mucosal healing and growth of patients were compared between patients younger and older than 6 years of age. Loss of response or non-response to infliximab and adverse events were assessed during the entire treatment period. Results Sixty-five patients were enrolled in the study. Sixty-four percent and 40.0% of very early onset Crohn’s disease patients achieved clinical remission and mucosal healing after induction therapy. Adjusted for the covariances, very early disease onset had no association with primary non-response ( p = 0.360) or mucosal healing ( p = 0.361). Early disease onset was associated with discontinuation of infliximab due to adverse events (hazard ratio [HR] 7.15, 95% CI 1.73–29.51, p = 0.006). Patients < 6 years had lower body mass index for age z score improvement during the induction phase ( p = 0.04). Conclusions Very early onset Crohn’s disease patients had similar non-response rates and mucosal healing rates as those who were 6 years or older during induction therapy. Greater discontinuation of infliximab due to adverse events was observed in very early onset Crohn’s disease patients.