Positive impact of blocking tumor necrosis factor α on the nutritional status in pediatric Crohn’s disease patients

Diamanti, A.; Basso, M. S.; Gambarara, M.; Papadatou, B.; Bracci, F.; Noto, C.; Castro, M.
January 2009
International Journal of Colorectal Disease;Jan2009, Vol. 24 Issue 1, p19
Academic Journal
TNFα seems to contribute to inflammation and malnutrition in Crohn’s disease (CD) patients. In CD patients, the comparative effects on nutritional status of infliximab and traditional therapy have not yet been determined. The aim of our study was to assess the effects of infliximab as compared with those of standard therapy on nutritional status, disease activity, resting energy expenditure (REE), and food intake in CD children and adolescents. From September 1999 to September 2005, all CD patients treated with infliximab (group A) were reviewed and matched with CD patients treated with traditional therapy (mesalazine and azathioprine) (group B). Fourteen CD patients from group A and 14 from group B were included; median interval before follow-up investigation was 10 months. Baseline and final values of weight, height, body mass index (BMI), pediatric CD activity index (pCDAI), REE, and food intake were studied. In treated patients, but not in control group, mean baseline weight (kg) and BMI values, 39.7 ± 13.1 and 17.9 ± 3.3, respectively, were significantly lower than their final values 42.6 ± 13.2 and 18.9 ± 3.1, and median pCDAI values 23.5 were significantly higher than their final values 10 ( P < 0.05). Significant changes in height, REE, and food intake were not found in either group. In pediatric CD patients, infliximab seems to impact positively on the nutritional status as demonstrated by the improvement in weight and BMI, but not in linear growth; effects on nutritional status seem to be due to amelioration of disease activity, rather than to REE reduction or food intake increase.


Related Articles

  • NEW THERAPY FOR OROLARYNGEAL MANIFESTATIONS OF CROHN'S DISEASE. Ottoviani, Francesco; Schindler, Antonio; Petrone, Mara; Capaccio, Pasquale; Porro, Gabriele Bianchi // Annals of Otology, Rhinology & Laryngology;Jan2003, Vol. 112 Issue 1, p37 

    Crohn's disease is a chronic inflammation that may involve the entire gastrointestinal tract, from the mouth to the anus. The most widely accepted etiologic theory involves an immunologic aberration leading to local tissue destruction. Cell-mediated immunity with increased tumor necrosis factor...

  • Editorial: Anti-TNF Treatment in Crohn's Disease: Toward Tailored Therapy? D'Haens, Geert // American Journal of Gastroenterology;May2010, Vol. 105 Issue 5, p1140 

    Infliximab is a potent therapy for induction and maintenance of remission in Crohn's disease. Unfortunately, many patients lose response and/or develop allergic reactions caused by the chimeric antibody. By means of measuring the presence of antibodies against infliximab and the trough levels of...

  • Is there a Benefit from the Concomitant Use of Immunosupression with Anti-TNF in Crohn's Disease; Heads or Tails? Lakatos, Peter Laszlo // Reviews on Recent Clinical Trials;Sep2009, Vol. 4 Issue 3, p152 

    Over the last some years the increasing knowledge on the pathogenesis of Crohn's disease led to the development of a number of biological agents targeting specific molecules involved in gut inflammation, first of all TNF-a and its receptors. Infliximab, adalimumab and certolizumab have been...

  • Adalimumab Induction Therapy for Crohn Disease Previously Treated with Infliximab. Sandborn, William J.; Rutgeerts, Paul; Enns, Robert; Hanauer, Stephen B.; Colombel, Jean-Frédéric; Panaccione, Remo; D'Haens, Geert; Li, Ju; Rosenfeld, Marie R.; Kent, Jeffrey D.; Pollack, Paul F. // Annals of Internal Medicine;6/19/2007, Vol. 146 Issue 12, p829 

    Background: Adalimumab, a fully human tumor necrosis factor (TNF) antagonist, is an effective treatment for patients with Crohn disease who are naive to the chimeric TNF antagonist, infliximab. No anti-TNF agent has been evaluated prospectively in patients with Crohn disease who had responded to...

  • GAIN for Loss: Adalimumab for Infliximab-Refractory Crohn Disease. Mannon, Peter // Annals of Internal Medicine;6/19/2007, Vol. 146 Issue 12, p888 

    The article focuses on effectiveness regarding the use of adalimumab in treating infliximab-refractory Crohn's disease. The author pointed about that anti-tumor necroses factors have limitations in treating Crohn's disease wherein about 40 percent patients do not respond to infliximab and...

  • Anti-TNF antibody therapy in Crohn's disease: the risk of a switch. Elena Ricart // Gut;Feb2012, Vol. 61 Issue 2, p169 

    The authors discuss a study of G. Van Assche and colleagues on the impact of elective switching from infliximab to adalimumab in patients with Crohn's disease with long-term sustained clinical response to infliximab (SWITCH trial). They say that the elective switching in patients with otherwise...

  • Tumor Necrosis Factor-Alpha Binding Capacity and Anti-Infliximab Antibodies Measured by Fluid-Phase Radioimmunoassays as Predictors of Clinical Efficacy of Infliximab in Crohn's Disease. Ainsworth, Mark A.; Bendtzen, Klaus; Brynskov, Jørn // American Journal of Gastroenterology;Apr2008, Vol. 103 Issue 4, p944 

    OBJECTIVES: To investigate if the combined assessment of anti-infliximab antibodies (Ab) and the degree of TNF-alpha binding capacity (TNF-alpha-BC) afforded by infliximab may predict the response to infliximab treatment in patients with Crohn's disease (CD). METHODS: Three groups of CD...

  • Scheduled Maintenance Therapy with Infliximab Improves the Prognosis of Crohn's Disease: A Single Center Prospective Cohort Study in Japan. Takahashi, Shuichiro; Takagi, Sho; Shiga, Hisashi; Umemura, Ken; Endo, Katuya; Kakuta, Yoichi; Takahashi, Seiichi; Kinouchi, Yoshitaka; Shimosegawa, Tooru // Tohoku Journal of Experimental Medicine;Mar2010, Vol. 220 Issue 3, p207 

    The main goal of Crohn's disease (CD) treatment at present is to induce and maintain remission for as long as possible, and several approaches have been used as induction and maintenance therapies. There are no reports that have compared the effects on mid- and long-term prognosis among the...

  • Selective effect of infliximab on the inflammatory component of a colonic stricture in Crohn’s disease. Sorrentino, Dario; Avellini, Claudio; Beltrami, Carlo Alberto; Pasqual, Enrico; Zearo, Ester // International Journal of Colorectal Disease;May2006, Vol. 21 Issue 3, p276 

    Although infliximab has been shown to improve the clinical course of Crohn’s disease, its effect on intestinal strictures is controversial. We describe the case of a woman with steroid-resistant colonic Crohn’s disease presenting with intermittent obstruction because of a tight...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics