Earlier Infliximab Initiation Is Associated with Endoscopic Healing in Pediatric Crohn’s Disease

Background/Objectives: This study aimed to identify clinical factors associated with endoscopic healing (EH) in pediatric patients with Crohn’s disease (CD) treated with infliximab (IFX). Methods: We performed a mixed retrospective/prospective registry-based cohort analysis using data from the Childhood & Adolescent Registry of Korean Inflammatory Bowel Disease (CARE-KIDS). Pediatric patients diagnosed with CD before 18 years of age who received IFX and underwent follow-up endoscopy were included. EH was defined as a Simple Endoscopic Score for Crohn’s Disease (SES-CD) < 3. Clinical variables, including the interval from diagnosis to IFX initiation, were evaluated using univariable logistic regression. Results: A total of 150 patients were included (median age at diagnosis, 14.4 years; 66.0% male). EH was present in 85 patients (56.7%) at the first follow-up endoscopy, performed at a median of 1.20 years (IQR, 1.02–1.98) after IFX initiation. There were no significant differences in sex, age at diagnosis, disease location, behavior, perianal involvement, growth status, or laboratory markers between the EH and non-EH groups. However, patients with EH had a shorter disease duration before IFX initiation than those without EH (median 0.19 vs. 0.38 years, p = 0.041). A longer interval from diagnosis to IFX initiation was associated with lower odds of EH (unadjusted OR per one-year increase, 0.21; 95% CI, 0.07–0.58; p = 0.004). Conclusions: Earlier IFX initiation was associated with EH in pediatric CD. These findings are consistent with a potential therapeutic window, although the observational analysis does not establish causality or an optimal treatment initiation cutoff.

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Publication Details

Journal
Children
Published
2026-10-28
DOI
https://doi.org/10.3390/children13111488
Primary Topic
Inflammatory Bowel Disease
Type
article
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article

Earlier Infliximab Initiation Is Associated with Endoscopic Healing in Pediatric Crohn’s Disease

Soon Chul Kim, Ben Kang, Byung‐Ho Choe, Ji Sook Park et al.
Children
Inflammatory Bowel Disease
article

Earlier Infliximab Initiation Is Associated with Endoscopic Healing in Pediatric Crohn’s Disease

Soon Chul Kim, Ben Kang, Byung‐Ho Choe, Ji Sook Park, Yon Ho Choe, Eell Ryoo, Minsoo Shin, Jung Ok Shim, Jin Soo Moon, Yoo Min Lee, Hye Ran Yang, Yoon Min Lee, Tae Hyeong Kim, So Yoon Choi, Hong Koh, Yeoun Joo Lee, Ju Young Chang
article en

Abstract

Background/Objectives: This study aimed to identify clinical factors associated with endoscopic healing (EH) in pediatric patients with Crohn’s disease (CD) treated with infliximab (IFX). Methods: We performed a mixed retrospective/prospective registry-based cohort analysis using data from the Childhood & Adolescent Registry of Korean Inflammatory Bowel Disease (CARE-KIDS). Pediatric patients diagnosed with CD before 18 years of age who received IFX and underwent follow-up endoscopy were included. EH was defined as a Simple Endoscopic Score for Crohn’s Disease (SES-CD) < 3. Clinical variables, including the interval from diagnosis to IFX initiation, were evaluated using univariable logistic regression. Results: A total of 150 patients were included (median age at diagnosis, 14.4 years; 66.0% male). EH was present in 85 patients (56.7%) at the first follow-up endoscopy, performed at a median of 1.20 years (IQR, 1.02–1.98) after IFX initiation. There were no significant differences in sex, age at diagnosis, disease location, behavior, perianal involvement, growth status, or laboratory markers between the EH and non-EH groups. However, patients with EH had a shorter disease duration before IFX initiation than those without EH (median 0.19 vs. 0.38 years, p = 0.041). A longer interval from diagnosis to IFX initiation was associated with lower odds of EH (unadjusted OR per one-year increase, 0.21; 95% CI, 0.07–0.58; p = 0.004). Conclusions: Earlier IFX initiation was associated with EH in pediatric CD. These findings are consistent with a potential therapeutic window, although the observational analysis does not establish causality or an optimal treatment initiation cutoff.

ChildrenVol. 13(11)
Gachon University (KR), Seoul National University (KR), Gyeongsang National University (KR), Yonsei University (KR), Korea University Medical Center (KR), Seoul Metropolitan Government (KR), Kosin University Gospel Hospital (KR), Samsung Medical Center (KR), Seoul National University Hospital (KR), Seoul National University Bundang Hospital (KR), Kyungpook National University (KR), Gachon University Gil Medical Center (KR), SNUH SMG-SNU Boramae Medical Center (KR), Jeonbuk National University Hospital (KR), Kyung Hee University Hospital at Gangdong (KR), Yonsei University Health System (KR), Soonchunhyang University Hospital Bucheon (KR), Korea University Anam Hospital (KR), Pusan National University Children's Hospital (KR), Pusan National University (KR), Jeonbuk National University (KR), Sungkyunkwan University (KR), Kosin University (KR)
Good health and well-being
Openalex Percentile: Top 15%
Inflammatory Bowel Disease
DOIOpen Access PDFOpenAlex
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