Abstract
Objectives
The aim of our study was to assess the effectiveness and side-effect profile of a
combination of azithromycin and metronidazole (CD AZCRO) as alternative induction
therapy for 8 weeks in mild to moderately active paediatric Crohn’s disease (CD).
Methods
We performed a retrospective cohort study (11/2012-07/2023) of a regional paediatric
IBD service. Disease activity, faecal calprotectin (FC), C-reactive protein (CRP),
erythrocyte sedimentation rate (ESR), haematological parameters and albumin were
collected at baseline, 8 and 16 weeks. At week 8 patients were divided based on
PCDAI score and inflammatory markers (blood and stool) into: group 1 clinical
remission and group 2 non-remission.
Results
A total of 48 patients were initially identified of whom 44 were included in the intentionto-
treat (ITT) analysis. After 8 weeks, the overall remission rate was 64%. Of the 38
patients who completed the CD AZCRO course, 28 patients (74%) entered remission
(group 1) and 10 (26%) did not (group 2). At baseline a shorter disease duration, low
weight z-score and higher inflammatory burden (ESR, platelets, and FC levels) were
observed in group 2. After 8 weeks, group 1 showed improved CRP levels and higher
albumin and haemoglobin levels than group 2. Median FC declined significantly from
650 mcg/g at baseline to 190 mcg/g at week 8 in group 1 (p<0.001). At 16 weeks,
23/28 patients (82%) continued in clinical remission. Nausea and vomiting were
reported in 4/44 patients.
Conclusions
Our real-world data demonstrate that AZCRO represents an alternative induction
therapy for mild to moderate paediatric CD.
The aim of our study was to assess the effectiveness and side-effect profile of a
combination of azithromycin and metronidazole (CD AZCRO) as alternative induction
therapy for 8 weeks in mild to moderately active paediatric Crohn’s disease (CD).
Methods
We performed a retrospective cohort study (11/2012-07/2023) of a regional paediatric
IBD service. Disease activity, faecal calprotectin (FC), C-reactive protein (CRP),
erythrocyte sedimentation rate (ESR), haematological parameters and albumin were
collected at baseline, 8 and 16 weeks. At week 8 patients were divided based on
PCDAI score and inflammatory markers (blood and stool) into: group 1 clinical
remission and group 2 non-remission.
Results
A total of 48 patients were initially identified of whom 44 were included in the intentionto-
treat (ITT) analysis. After 8 weeks, the overall remission rate was 64%. Of the 38
patients who completed the CD AZCRO course, 28 patients (74%) entered remission
(group 1) and 10 (26%) did not (group 2). At baseline a shorter disease duration, low
weight z-score and higher inflammatory burden (ESR, platelets, and FC levels) were
observed in group 2. After 8 weeks, group 1 showed improved CRP levels and higher
albumin and haemoglobin levels than group 2. Median FC declined significantly from
650 mcg/g at baseline to 190 mcg/g at week 8 in group 1 (p<0.001). At 16 weeks,
23/28 patients (82%) continued in clinical remission. Nausea and vomiting were
reported in 4/44 patients.
Conclusions
Our real-world data demonstrate that AZCRO represents an alternative induction
therapy for mild to moderate paediatric CD.
| Original language | English |
|---|---|
| Journal | Journal of pediatric gastroenterology and nutrition |
| Publication status | Published - 9 Dec 2024 |