Adalimumab Treatment in Children with Refractory Crohn’s Disease

Abstract

Information on safety and efficacy of adalimumab in children with Crohn's disease (CD) is limited. We present a case-series of 14 children with severe CD treated with adalimumab during a 3.5-year period. Fourteen children (nine boys, five girls), aged 13.9 years (range 1.9-19.1) were treated with adalimumab during 12.5 months (range 7-42). All had steroid or immunosuppression-drugs refractory disease. Ten patients (71%) had been previously treated with infliximab, 13/14 were treated with different immunosuppressive drugs and all were steroid-dependent or resistant. Seven children (50%) showed full clinical response and 5/14 (35%) improved partially. Two children (15%) had loss of response after a period of transient improvement. Adalimumab treatment enabled complete steroids withdrawal in 8/14 (57%) of steroid-dependent children. Currently, five children are in complete remission with adalimumab monotherapy for a median 14 months (range 9-24). Adalimumab may induce and maintain remission in children with severe, refractory CD. Prospective safety and efficacy confirmation of this data in children is necessary.

A British Society of Paediatric Gastroenterology, Hepatology and Nutrition survey of the effectiveness and safety of adalimumab in children with inflammatory bowel disease

“…The published experience to date of adalimumab in children with the exception of one large retrospective study 20 is limited mostly to case reports [21][22][23][24] and small clinical case series. [25][26][27][28] However, it is increasingly clear that adalimumab is used widely in paediatric clinical practice.…”

Disease Status and Pubertal Stage Predict Improved Growth in Antitumor Necrosis Factor Therapy for Pediatric Inflammatory Bowel Disease

“…Israel which found no improvement in height at last follow up (median of 17.3 months) again no pubertal data was provided 43 .…”

Adalimumab: a review of the reference product and biosimilars

“…As in the case of adults, adalimumab is efficacious in the treatment of CD among children, including those without response to infliximab. 46,47…”