Biologics in pediatric Crohn’s disease: is it time to move to an earlier therapeutic approach?

Abstract

The treatment of Crohn’s disease in children has undergone a revolution in the past decade following studies that have demonstrated the efficacy of anti-TNFα agents in producing durable clinical response/remission as well as reversal of growth delay in many patients. The positioning of biologic therapy continues to be debated. Should it be reserved for children failing conventional therapy including immunomodulators or should it be used as primary therapy shortly after diagnosis in children with more severe disease likely to suffer a more complicated disease course? Risk stratification will be crucial to any therapeutic decisions and emerging data hold promise that identification of those most likely to benefit will be available in the near future.

Keywords::

• anti-TNFα
• biological therapy
• children
• Crohn’s disease
• immunomodulators
• risk stratification

Financial & competing interests disclosure

JS Hyams has received research support, been on the advisory board and part of the speaker’s bureau for Janssen. He has been a consultant for Soligenix, TNI Biotech and Takeda; and he has received research support and been on the advisory board for Abbvie. The author have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.