• Development of peripheral eosinophilia in inflammatory bowel disease patients on infliximab treated at a tertiary pediatric inflammatory bowel disease center is associated with clinically active disease but does not result in loss of efficacy or adverse outcomes

      Zabrowski, D.; Abraham, D.; Rosenthal, G.; Kader, H. (John Wiley and Sons Inc., 2020)
      Introduction: Inflammatory bowel disease (IBD) consisting of Crohn's disease(CD) and ulcerative colitis (UC) are inflammatory conditions affecting the gastrointes-tinal tract. Infliximab (IFX) is a chimeric anti-tumor necrosis factor antibody used totreat moderate to severe IBD. Eosinophils are commonly found in chronicallyinflamed tissues in IBD. Peripheral eosinophilia (PE) was previously implicated as amarker of disease severity at diagnosis. The main aim of this study was to investigatewhether in IBD patients on IFX, development of PE is associated with adverse out-comes and poor IFX efficacy.Methods:A comprehensive retrospective chart review of IBD patients on IFX(January 2006 to July 2015) treated at a tertiary pediatric IBD center was performed.Data was collected at time specified points over a 24 month period and includeddemographics, atopy, disease severity, development of PE, human antichimeric anti-bodies (HACA), infusion reactions, cancer, psoriasis, and loss of clinical response.Results:One hundred twenty-one IBD patients starting IFX (67 male), mean age of12.4 years (range 4-22 years old), met inclusion criteria. Of them, 36.3% had?1PEepisode (CD: 25 male, 11 female; UC: 6 male, 2 female). Mean absolute eosinophilcount (AEC) did not change over time. PE was associated with clinically active dis-ease. Among patients who developed PE, adverse outcomes were not significantly dif-ferentversusthose who did not have PE.Conclusions:In a cohort of primarily pediatric IBD patients on IFX, PE was associ-ated with clinically active disease; however, PE was not related to increased incidenceof adverse outcomes or loss of drug efficacy. Copyright 2020 The Authors.