Original article—alimentary tractImprovement in Biomarkers of Bone Formation During Infliximab Therapy in Pediatric Crohn's Disease: Results of the REACH Study
Section snippets
REACH: Study Subjects and Design
The REACH international multicenter, randomized, open-label study enrolled 112 subjects from February 2003 through March 2004. The institutional review boards at participating sites approved the protocol. Written informed consent was obtained from all parents/legal guardians, and assent was obtained from children on the basis of individual institutional review board guidelines.
The details of the study protocol were previously described.27 Briefly, subjects were 6–17 years of age, with
Subject Characteristics
Table 1 summarizes baseline subject characteristics. The baseline deficits in height and BMI z-scores reflect the growth and nutritional status in subjects with moderate to severe CD. On average, the baseline chronologic age was 0.77 ± 1.43 years greater than the bone age. Baseline PCDAI scores, bone age deficits, and height z-scores did not differ in the 36 subjects concurrently treated with corticosteroids, compared with the remaining 77 subjects. There were no gender differences in growth
Discussion
This prospective multicenter study is the first to examine changes in bone biomarkers during infliximab induction therapy in children and adolescents with CD. These data demonstrated marked increases in bone formation biomarkers and moderate increases in bone resorption markers. On average, BSAP increased 109% and P1NP increased 208% (P < .001). The magnitude of these increases is substantially greater than the 15%–26% increases in bone formation markers in adult studies, as detailed below. In
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The authors would like to acknowledge Karen Hayden and Harry Walton for their technical support and Grace Lang and Stephen Xu for statistical support.
The authors disclose the following: Centocor, Inc, Malvern, PA provided support for this study.
Allan Olson is currently employed at Robert Wood Johnson Pharmaceutical Research and Development and is a former employee of Centocor, Inc. Jewel Johanns, and Colleen Marano are employees of Centocor Inc. Jeffrey Hyams received research funding in conjunction with the conduct of this study and other studies sponsored by Centocor and served as a consultant to Centocor. Wallace Crandal and Subra Kugathasan received research funding in conjunction with the conduct of this study, served as a consultant to Centocor, and received an honorarium from Centocor. Robert Heuschkel received research funding in conjunction with the conduct of this study and also received a grant from Schering-Plough. Anthony Otley, Gigi Veereman-Wauters, Anne Griffiths, and Robert Baldassano received research funding in conjunction with the conduct of this study.