دورية أكاديمية
أعرض في EDS

Liver enzyme profiles after initiating biological treatment in children with inflammatory bowel diseases.

التفاصيل البيبلوغرافية
العنوان: Liver enzyme profiles after initiating biological treatment in children with inflammatory bowel diseases.
المؤلفون: Räisänen L; Department of Pediatrics, Tampere University Hospital, Tampere, Finland.; Department of Pediatrics, Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland., Nikkonen A; Department of Pediatrics, Faculty of Medicine and Children's Hospital, Helsinki University Hospital HUS, University of Helsinki, Helsinki, Finland., Kolho KL; Department of Pediatrics, Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland.; Department of Pediatrics, Faculty of Medicine and Children's Hospital, Helsinki University Hospital HUS, University of Helsinki, Helsinki, Finland.
المصدر: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2024 Sep; Vol. 79 (3), pp. 583-591. Date of Electronic Publication: 2024 Jul 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8211545 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-4801 (Electronic) Linking ISSN: 02772116 NLM ISO Abbreviation: J Pediatr Gastroenterol Nutr Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : Philadelphia, PA : Lippincott Williams & Wilkins
Original Publication: [New York, N.Y.] : Raven Press, [c1982-
مواضيع طبية MeSH: Alanine Transaminase*/blood , Inflammatory Bowel Diseases*/drug therapy , Inflammatory Bowel Diseases*/blood , Infliximab*/therapeutic use, Humans ; Male ; Female ; Child ; Adolescent ; gamma-Glutamyltransferase/blood ; Liver ; Finland ; Gastrointestinal Agents/therapeutic use ; Child, Preschool ; Adalimumab/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; Retrospective Studies ; Ustekinumab/therapeutic use ; Biological Therapy/methods
مستخلص: Objectives: Biological treatments (BTs) are essential in managing pediatric inflammatory bowel diseases (PIBDs). Elevated liver enzymes sometimes succeed BT, yet elucidating studies are scarce. We addressed liver biochemistry after introducing BT and searched for their determinants.
Methods: We identified PIBD patients receiving infliximab, adalimumab, vedolizumab, or ustekinumab at the Children's Hospital, University of Helsinki, Finland, in 2000-2023, and followed their alanine transaminase (ALT) and γ-glutamyl transpeptidase (GT) levels for 24 months. ALT was categorized based on the age- and sex-specific upper limit of normal. We disregarded 46 patients with underlying primary sclerosing cholangitis with/without autoimmune hepatitis (AIH), pretreatment AIH diagnosis, and elevated liver enzymes at the beginning of BT from the analyses.
Results: Of 618 BT episodes in 403 patients, 22.2% exhibited increased ALT or GT (ALT in 117, GT in 4, and both ALT/GT in 16 episodes). Of all ALT elevations (n = 133), 41.4% occurred within the first 3 months. ALT elevation was more common after infliximab (representing 59.5% of BTs) than other BTs (25.9% vs. 14.2%, adjusted odds ratio [OR]: 2.41, 95% confidence interval [CI]: 1.23-4.72). AIH followed 1.5% (n = 9) of BT episodes. Ninety-five percent of ALT elevations resolved within 6 months. Antibiotic exposure (particularly to metronidazole) was associated with ALT elevation in general (adjusted OR: 5.76, 95% CI: 2.40-13.9) and short disease duration before starting BT with notable ALT elevation (adjusted OR: 1.10, 95% CI: 1.01-1.22).
Conclusions: Benign ALT elevation is common within 3 months after starting BT (especially infliximab) and scarcely led to cessation of the treatment. AIH is a rare finding during the first year of BT.
(© 2024 The Author(s). Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
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معلومات مُعتمدة: Pediatric Research Foundation, the Orion Pharma Foundation, and Helsinki University Hospital Research Fund
فهرسة مساهمة: Keywords: Crohn disease; adalimumab; anti‐TNF‐α; infliximab; pediatric
المشرفين على المادة: EC 2.6.1.2 (Alanine Transaminase)
B72HH48FLU (Infliximab)
EC 2.3.2.2 (gamma-Glutamyltransferase)
0 (Gastrointestinal Agents)
FYS6T7F842 (Adalimumab)
0 (Antibodies, Monoclonal, Humanized)
9RV78Q2002 (vedolizumab)
FU77B4U5Z0 (Ustekinumab)
تواريخ الأحداث: Date Created: 20240701 Date Completed: 20240925 Latest Revision: 20240925
رمز التحديث: 20240926
DOI: 10.1002/jpn3.12300
PMID: 38946705
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-4801
DOI:10.1002/jpn3.12300