dc.contributor.author | Merrick, VM | en_US |
dc.contributor.author | Mortier, K | en_US |
dc.contributor.author | Williams, LJ | en_US |
dc.contributor.author | Muhammed, R | en_US |
dc.contributor.author | Auth, MK | en_US |
dc.contributor.author | Elawad, M | en_US |
dc.contributor.author | Fell, JM | en_US |
dc.contributor.author | Beattie, RM | en_US |
dc.contributor.author | Loganathan, S | en_US |
dc.contributor.author | Torrente, F | en_US |
dc.contributor.author | Morris, M-A | en_US |
dc.contributor.author | Charlton, C | en_US |
dc.contributor.author | Croft, NM | en_US |
dc.contributor.author | Rodrigues, A | en_US |
dc.contributor.author | Furman, M | en_US |
dc.contributor.author | Vadamalayan, B | en_US |
dc.contributor.author | Jenkins, H | en_US |
dc.contributor.author | Zamvar, V | en_US |
dc.contributor.author | Mitton, SG | en_US |
dc.contributor.author | Chong, S | en_US |
dc.contributor.author | Cosgrove, M | en_US |
dc.contributor.author | Akobeng, A | en_US |
dc.contributor.author | Wilson, DC | en_US |
dc.contributor.author | Russell, RK | en_US |
dc.date.accessioned | 2017-08-29T09:36:30Z | |
dc.date.available | 2017-06-19 | en_US |
dc.date.issued | 2017-07-27 | en_US |
dc.date.submitted | 2017-08-14T17:46:22.207Z | |
dc.identifier.uri | http://qmro.qmul.ac.uk/xmlui/handle/123456789/25504 | |
dc.description.abstract | OBJECTIVES: To measure the effectiveness, safety and use of anti-Tumour necrosis Factor (TNF) therapy in paediatric inflammatory bowel disease (PIBD) in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment (PGA) +/or the Paediatric Crohn's Disease Activity Index (PCDAI). RESULTS: 37 centres participated (23 of 25 specialist PIBD sites). 524 patients were included; 429 Crohn's disease (CD), 76 ulcerative colitis (UC), 19 IBD unclassified (IBDU). 87% (488/562) anti-TNF was infliximab; commonest indication was active luminal CD 77% (330/429) or chronic refractory UC/IBDU 56% (53/95); 79% (445/562) had concomitant co-immunosuppression. In CD (267/429 male), median time from diagnosis to treatment was 1.42 years (IQR 0.63-2.97). Disease (at initiation) was moderate or severe in 91% (156/171) by PGA compared to 41% (88/217) by PCDAI; Kappa (Κ) 0.28 = only 'fair agreement' (p < 0.001).Where documented, 77% (53/69) of CD patients responded to induction; and 65% (46/71) entered remission. 2287 infusions and 301.96 years of patient follow-up (n = 385) are represented; adverse events affected 3% (49/1587) infliximab and 2% (2/98) adalimumab infusions (no deaths or malignancies). Perianal abscess drainage was less common after anti-TNF initiation (CD): 26% (27/102) before, 7% (3/42) after (p = 0.01); however pre and post anti-TNF data collection was not over equal time periods. CONCLUSION: Anti-TNFs are effective treatments, usually given with thiopurine co-immunosuppression. This study highlights deficiencies in formal documentation of effect and disparity between disease severity scoring tools which need to be addressed to improve ongoing patient care. | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | J Pediatr Gastroenterol Nutr | en_US |
dc.rights | This is an Accepted Manuscript of an article published by Lippincott, Williams & Wilkins in Journal of Pediatric Gastroenterology and Nutrition available online: https://doi.org/10.1097/MPG.0000000000001679 | |
dc.title | Real-Life Anti-Tumour Necrosis Factor Experience in > 500 Paediatric United Kingdom Inflammatory Bowel Disease Patients. | en_US |
dc.type | Article | |
dc.rights.holder | (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, | |
dc.identifier.doi | 10.1097/MPG.0000000000001679 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/28753181 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |