Publications by authors named "Dwight A Winter"

Article Synopsis
  • The study investigates the differences in anti-tumour necrosis factor (TNF) treatment response between pediatric (pIBD) and adult (aIBD) inflammatory bowel disease patients, highlighting that children often experience a loss of response in their first year on medication.
  • Researchers conducted a prospective, observational study comparing biomarkers from both groups, monitoring treatment escalation and drug levels over 18 months.
  • The findings revealed that treatment escalation occurred more frequently in pIBD patients, and while no biomarkers for maintained response were identified, nine pro-inflammatory proteins emerged as potential predictors for loss of response in this group.
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Infliximab (IFX) is administered intravenously using weight-based dosing (5 mg/kg) in inflammatory bowel disease (IBD) patients. Our hypothesis is that especially young children need a more intensive treatment regimen than the current weight-based dose administration. We aimed to assess IFX pharmacokinetics (PK), based on existing therapeutic drug monitoring (TDM) data in IBD patients < 10 years.

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Objectives: Infliximab (IFX), a monoclonal antibody directed against tumor necrosis factor alpha is a potent treatment option for inflammatory bowel disease (IBD). Dosing regimens in children are extrapolated from adult data using a fixed, weight-based dose, which is often not adequate. While clinical trials have focused on safety and efficacy, there is limited data on pharmacokinetic characteristics and immunogenicity of IFX in children.

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Background: Inflammatory bowel disease-unclassified (IBD-U) is diagnosed in ∼10% of pediatric and adolescent onset IBD patients. The EUROKIDS registry (2004) initiated by the Porto IBD working group of ESPGHAN prospectively monitors diagnostic workup of newly diagnosed pediatric and adolescent onset IBD patients. We aimed to describe diagnostic workup, phenotype, and change of diagnosis over time in pediatric IBD-U patients.

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