Long-term Outcomes of Infliximab use for Pediatric Crohn's disease: A Canadian Multicenter Clinical Practice Experience.

Background: Data on long-term real-world outcomes of infliximab in pediatric Crohn's disease are limited. Aim: To evaluate infliximab optimization and durability in children with Crohn's disease. Methods: We performed a retrospective review of children with Crohn's disease who started infliximab from January 2008-December 2012 in 4 Canadian tertiary-care centers. A priori factors associated with optimization and discontinuation from loss of response were evaluated using logistic regression and Cox proportional hazards model, respectively. Results: One-hundred and eighty children (54.4% males) started infliximab; all completed induction. Median age at infliximab start was 14.3 years (Q1,Q3:12.8, 15.9 years) and median time from diagnosis to infliximab start was 1.5 years (Q1,Q3:0.6, 3.5 years). At last follow-up, 87.1% were maintained on infliximab (median duration follow-up 85.9 weeks [Q1,Q3:43.8, 138.8 weeks]). Infliximab optimization occurred in 57.3% (dose escalation 15.2%, interval shortening 3.9%, both 38.2%), primarily due to loss of response. Younger age at diagnosis (

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