#6 The Outcome of Adalimumab therapy in Pediatric IBD: A Single Centre Study
Adalimumab (ADA) is an anti-tumor necrosis factor biological medicine that has been used to treat patients with inflammatory bowel diseases (IBD), including Crohn’s disease (CD) or ulcerative colitis (UC). This study is meant to examine clinical and laboratory outcomes in Manitoban children with IBD.
In a retrospective study, all consecutive children (<18 years) with IBD treated with ADA from January 2012 to August 2017 were recruited. Patient characteristics, ADA dose, concomitant therapies, clinical assessment, laboratory markers including c-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (HGB), platelet count (PLT), and serum albumin (ALB) level and reported ADA-related adverse events were recorded.
A total of 14 children (median age 14 years, IQ 6-18; 9 girls (64%); CD 12, UC 1, IBD unclassified 1) were included. Median duration of treatment was 599 days, IQR=7-1337 days). 7 patients (50%) were on concomitant therapy with immunosuppressants [5 were on oral methotrexate, 2 were on azathioprine]. Ten patients (71%) received maintenance injections every other week while four patients (29%) received weekly injections. Laboratory markers before and after ADA treatment (CRP: median=28mg/L, 6.14mg/L; IQR: <1 – 114 mg/L, <1 – 30 mg/L; p = 0.0283; ESR: median=61.9mm/hr,28.3mm/hr; IQR=22-99mm/hr, 7 – 99mm/hr;p = 0.046 HGB: median=112g/L, 126g/L; IQR=75-128g/L, 101-150;p = 0.035 ;PLT: median=360 10E9/L, 332 10E9/L; IQR=77-840 10E9/L, 187-840 10E9/L ;p = 0.363; ALB: median=35g/L, 37.25g/L; IQR=25-42g/L, 31-45g/L; p = 0.405). Ten out of 14 (71%) patients achieved and maintained remission while 4/14 (29%) patients had to be switched for a different medication for active disease.
Children with IBD especially those with CD show a good response to ADA treatment.