Original Article

Digestive Diseases and Sciences

, Volume 55, Issue 3, pp 747-753

First online:

Adalimumab Treatment in Children with Refractory Crohn’s Disease

  • Yoram RosenbachAffiliated withInstitute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University
  • , Corina HartmanAffiliated withInstitute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University Email author 
  • , Rivka ShapiroAffiliated withInstitute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University
  • , Akiva HirschAffiliated withInstitute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University
  • , Yaron AvitzurAffiliated withInstitute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University
  • , Raanan ShamirAffiliated withInstitute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University

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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.

Keywords

Crohn’s disease Adalimumab Infliximab Children