© Springer International Publishing AG 2018 163
A.S. Cheifetz, J.D. Feuerstein (eds.), Treatment of Inflammatory
Bowel Disease with Biologics, https://doi.org/10.1007/978-3-319-60276-9_11
Chapter 11
Biologic Therapy in Pediatric Inflammatory
Bowel Disease
Sonal Patel and Jennifer Strople
Over the past several decades, there has been an increasing incidence of pediatric
inflammatory bowel disease (IBD) internationally [ 1 ]. Pediatric patients often have
more severe and extensive disease when compared to adult presentation, with more
panenteric and colonic involvement in Crohn’s disease and pancolitis in ulcerative
colitis, which may impact disease course and response to therapy [ 2 , 3 ]. Many
unique considerations must be taken into account when selecting the optimal ther-
apy for a pediatric patient with IBD, including the effect of therapy on growth
parameters, the cumulative or long-term adverse effects of multiple treatments over
the course of a patient’s life, and the inherently longer duration of treatment given
the age of diagnosis. Biologic agents have been used for the treatment of pediatric
IBD for more than 20 years, and these therapies have not only improved clinical
and histologic evidence of bowel inflammation in patients who have refractory or
severe disease but have also led to substantial improvement in the quality of life of
these patients.
Infliximab for Pediatric Crohn’s Disease
Infliximab, a monoclonal, chimeric antibody which acts as an antagonist to TNF-α,
has been used for the treatment of pediatric Crohn’s disease (CD) for over 20 years;
however, the medication only recently received FDA approval in 2006 for the treat-
ment of moderately to severely active pediatric CD. Initial reports of use in pediatric
CD focused on small numbers of patients receiving spot or induction dosing of
S. Patel • J. Strople (*)
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ann and Robert H. Lurie
Children’s Hospital of Chicago, Chicago, IL, USA
e-mail: [email protected]