Therapeutic effect of adalimumab in the treatment of intestinal Behçet's disease in children.

IF 2.1 3区 医学 Q2 PEDIATRICS
Frontiers in Pediatrics Pub Date : 2025-06-30 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1619065
Tianjiao Gao, Xiaoxia Ren, Yanan Han, Fengfan Wang, Bianhua Liu, Ying Fang
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引用次数: 0

Abstract

Objective: Intestinal Behçet's disease is a rare but severe manifestation of Behçet's disease, particularly in pediatric populations. Currently, there is no cure for intestinal Behçet's disease, and the goal of treatment is to control acute episodes and reduce inflammation. Adalimumab, a tumor necrosis factor-alpha (TNF-α) inhibitor, has shown promise in adult patients, but data on its efficacy and safety in children are limited. The aim of this study was to evaluate the efficacy and safety of adalimumab in the treatment of intestinal Behçet's disease in children.

Methods: A retrospective analysis was conducted on 8 children with intestinal Behçet's disease treated with adalimumab at Xi'an Children's Hospital from January 2021 to December 2024. Clinical symptoms, endoscopic findings, and inflammatory markers were assessed before and after treatment. Efficacy was evaluated on the basis of symptom resolution, ulcer healing, and changes in inflammatory markers.

Results: The cohort included 4 males and 4 females, with an average age of 11.9 ± 1.4 years and a disease course of 10.5 (6.75, 22.5) months. All patients presented with gastrointestinal symptoms, including abdominal pain (n = 7), vomiting (n = 1), and complications such as intestinal obstruction (n = 3) and perforation (n = 1). Colonoscopy revealed ileocecal ulcers in 7 patients and only terminal ileal ulcers in 1 patient. After treatment with adalimumab, complete resolution of clinical symptoms was observed in all patients. Gastrointestinal endoscopy revealed that 6 patients had completely healed ulcers, while the remaining 2 patients had ulcers that were reduced to 50% of their original size. The levels of inflammatory markers significantly decreased, with the erythrocyte sedimentation rate (ESR) decreasing from 44.63 ± 43.48 mm/h to 10.50 ± 7.65 mm/h (p = 0.046) and the high sensitivity C-reactive protein (hs-CRP) level decreasing from 43.87 ± 39.10 mg/L to 0.96 ± 0.67 mg/L (p = 0.017). On the basis of clinical symptoms and endoscopic findings, 6 patients (75%) achieved complete remission, and 2 patients (25%) showed improvement. Adalimumab was well tolerated, with only one case of mild eczema reported.

Conclusion: Adalimumab is safe and effective in the treatment of intestinal Behçet's disease in children.

阿达木单抗治疗儿童肠道behaperet病的疗效观察。
目的:肠道behet病是一种罕见但严重的behet病表现,特别是在儿童人群中。目前,还没有治愈肠道behet病的方法,治疗的目标是控制急性发作和减少炎症。阿达木单抗是一种肿瘤坏死因子-α (TNF-α)抑制剂,已在成人患者中显示出前景,但其在儿童中的有效性和安全性数据有限。本研究的目的是评估阿达木单抗治疗儿童肠道behaperet病的有效性和安全性。方法:回顾性分析2021年1月至2024年12月在西安市儿童医院接受阿达木单抗治疗的8例肠道behaperet病患儿。治疗前后评估临床症状、内窥镜检查结果和炎症标志物。根据症状消退、溃疡愈合和炎症标志物的变化来评估疗效。结果:男性4例,女性4例,平均年龄11.9±1.4岁,病程10.5(6.75,22.5)个月。所有患者均出现胃肠道症状,包括腹痛(n = 7)、呕吐(n = 1)、肠梗阻(n = 3)和穿孔(n = 1)等并发症。结肠镜检查显示回盲溃疡7例,终末期回肠溃疡1例。阿达木单抗治疗后,所有患者的临床症状均完全缓解。胃肠道内窥镜检查显示,6例患者溃疡完全愈合,其余2例患者溃疡缩小到原始大小的50%。炎症标志物水平显著降低,红细胞沉降率(ESR)由44.63±43.48 mm/h降至10.50±7.65 mm/h (p = 0.046),高敏c反应蛋白(hs-CRP)由43.87±39.10 mg/L降至0.96±0.67 mg/L (p = 0.017)。根据临床症状和内镜检查结果,6例(75%)患者完全缓解,2例(25%)患者好转。阿达木单抗耐受性良好,仅有一例轻度湿疹报告。结论:阿达木单抗治疗儿童肠道beharseet病安全有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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