Discontinuation of Immunosuppressive Medications in Children With Inflammatory Bowel Disease on Combination Therapy. Issue 6 (December 2020)

• Record Type: Journal Article
• Authors: El-Matary, Wael; Carroll, Matthew W.; Debruyn, Jennifer C.; Huynh, Hien; Wine, Eytan; Lawrence, Sally; Chandrakumar, Abin; Morel, Terra; Jacobson, Kevan
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 71:Issue 6(2020)
• Publication Date: 2020-12
• Subjects: azathioprine -- biologics -- colitis -- Crohn -- infliximab -- methotrexate; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000002857
• Languages: English
• ISSNs: 0277-2116

Abstract

Abstract : ABSTRACT: We determined the frequency and factors associated with the first clinical relapse after immunomodulator (IM) withdrawal in a cohort of children with inflammatory bowel disease on combination therapy. A total of 105 patients (89 with Crohn disease [CD]) in clinical remission were included (91 [86.7%] were on infliximab, 53 [50.5%] with methotrexate, and 52 on azathioprine). The median duration of combination therapy was 2.1 years (interquartile range [IQR] 1.3–2.8). Only 11 (10.5%) patients experienced a clinical relapse over a median duration of follow-up of 12.0 months (IQR 5.0–19.0) after IM discontinuation. The median baseline pediatric CD activity index in those with CD who relapsed after IM discontinuation was 47.5 (IQR: 35.0–55.0) versus those who did not relapse (median 35.0, IQR: 20.0–52.5; P = 0.04). In the patients who did not relapse, the median IFX trough level at IM discontinuation was 6.2 and 3.8 μg/mL in those who relapsed.