OUTCOME OF INFLIXIMAB THERAPY IN PEDIATRIC CROHN'S DISEASE AT MCMASTER CHILDREN'S HOSPITAL
Bibliographic record
Abstract
Background and Aims: Despite the successful utilization of infliximab in adults, there have been few published pediatric trials. To analyze the outcome of consecutive pediatric Crohn's patients treated with infliximab at a tertiary medical center. Methods: Retrospective, 5-year single center open study on the outcome of Crohn's patients (<18 years) treated with infliximab (5-10 mg/kg iv). Indications were steroid-resistant (SR), or steroid-dependent (SD) Crohn's disease, despite the use of immunosuppresive drugs, or severe perianal disease/fistulae (PF). Primary outcome measures were clinical response (PCDAI and complete withdrawal of steroids) and the duration of response. Adverse events were assessed for all infusions. The minimum follow-up was 6 months after the first dose. Results: Twenty-one patients were treated with infliximab (2000 to 11/2005), but only 18 had a follow-up of at least 6 months. Patients had received 2-27 infusions (mean 12) for SD (12), SR (1) or PF (7). Disease distribution was ileocolitis (10), colitis (8), perianal (2) and duodenal (2). Concomitant immunosuppressives (6-MP or MTX) had already been employed in all patients. The mean follow-up time was 19 months (range: 6-31). A clinical response was observed in 15 (83%) of the patients. Dependence on infliximab (every ± 8 weeks to maintain remission) was encountered in all responders. In the first year (without pre-medication), 1 reaction occurred. Pre-medication (Solu-Cortef/Diphenhydramine) was employed for the subsequent infusions, and no reactions were observed. Conclusions: Infliximab is an effective biological therapy for pediatric Crohn's disease. The clinical outcome is similar to that reported in adults. Infusion reactions are very rare in children when initial infusion rates are slow, with the routine use of pre-medication. All responders became dependent on infliximab infusions every 2 months. Long-term follow-up of these children is warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".