Digestive Diseases and Sciences

, Volume 55, Issue 3, pp 747–753

Adalimumab Treatment in Children with Refractory Crohn’s Disease

  • Yoram Rosenbach
  • Corina Hartman
  • Rivka Shapiro
  • Akiva Hirsch
  • Yaron Avitzur
  • Raanan Shamir
Original Article


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.


Crohn’s disease Adalimumab Infliximab Children 


  1. 1.
    Turunen P, Kolho KL, Auvinen A, Iltanen S, Huhtala H, Ashorn M. Incidence of inflammatory bowel disease in Finnish children, 1987–2003. Inflamm Bowel Dis. 2006;12:677–683.CrossRefPubMedGoogle Scholar
  2. 2.
    Kamm MA. Review article: biological drugs in Crohn’s disease. Aliment Pharmacol Ther. 2006;24(Suppl 3):80–89.CrossRefPubMedGoogle Scholar
  3. 3.
    Hyams J, Crandall W, Kugathasan S, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn’s disease in children. Gastroenterology. 2007;132:863–873.CrossRefPubMedGoogle Scholar
  4. 4.
    Rutgeerts P, Van Assche G, Vermeire S. Review article: infliximab therapy for inflammatory bowel disease–seven years on. Aliment Pharmacol Ther. 2006;23:451–463.CrossRefPubMedGoogle Scholar
  5. 5.
    Nikolaus S, Schreiber S. Diagnostics of inflammatory bowel disease. Gastroenterology. 2007;133:1670–1689.CrossRefPubMedGoogle Scholar
  6. 6.
    Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–753.CrossRefPubMedGoogle Scholar
  7. 7.
    Harvey RF, Bradshaw MJ. Measuring Crohn’s disease activity. Lancet. 1980;1(8178):1134–1135.CrossRefPubMedGoogle Scholar
  8. 8.
    Lorenz HM. Technology evaluation: adalimumab, Abbott Laboratories. Curr Opin Mol Ther. 2002;4:185–190.PubMedGoogle Scholar
  9. 9.
    Hanauer SB, Sandborn WJ, Rutgeerts P, et al. Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I trial. Gastroenterology. 2006;130:323–333.CrossRefPubMedGoogle Scholar
  10. 10.
    Sandborn WJ, Hanauer SB, Rutgeerts P, et al. Adalimumab for maintenance treatment of Crohn’s disease: results of the CLASSIC II trial. Gut. 2007;56:1232–1239.CrossRefPubMedGoogle Scholar
  11. 11.
    Colombel JF, Sandborn WJ, Rutgeerts P, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology. 2007;132:52–65.CrossRefPubMedGoogle Scholar
  12. 12.
    Sandborn WJ, Rutgeerts P, Enns R, et al. Adalimumab induction therapy for Crohn's disease previously treated with infliximab: a randomized trial. Ann Intern Med. 2007;146:829–838.PubMedGoogle Scholar
  13. 13.
    Seiderer J, Brand S, Dambacher J, et al. Adalimumab in patients with Crohn’s disease—safety and efficacy in an open-label single centre study. Aliment Pharmacol Ther. 2007;25:787–796.PubMedGoogle Scholar
  14. 14.
    Peyrin-Biroulet L, Laclotte C, Bigard M-A. Adalimumab maintenance therapy for Crohn’s disease with intolerance or lost response to infliximab: an open-label study. Aliment Pharmacol Ther. 2007;25(6):675–680.PubMedGoogle Scholar
  15. 15.
    Ho G-T, Smith L, Aitken S, et al. The use of adalimumab in the management of refractory Crohn’s disease. Aliment Pharmacol Ther. 2008;27(4):308–315.PubMedGoogle Scholar
  16. 16.
    Hadziselimovic F. Adalimumab induces and maintains remission in severe, resistant paediatric Crohn's disease. J Pediatr Gastroenterol Nutr. 2008;46:208–211.CrossRefPubMedGoogle Scholar
  17. 17.
    Mian S, Baron H. Adalimumab, a novel anti-tumor necrosis factor-alpha antibody in a child with refractory Crohn’s disease. J Pediatr Gastroenterol Nutr. 2005;41:357–359.CrossRefPubMedGoogle Scholar
  18. 18.
    Hinojosa J, Gomollón F, García S, et al. Spanish scientific group on Crohn’s disease and ulcerative colitis. Efficacy and safety of short-term adalimumab treatment in patients with active Crohn’s disease who lost response or showed intolerance to infliximab: a prospective, open-label, multicentre trial. Aliment Pharmacol Ther. 2007;25:409–418.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Yoram Rosenbach
    • 1
  • Corina Hartman
    • 1
  • Rivka Shapiro
    • 1
  • Akiva Hirsch
    • 1
  • Yaron Avitzur
    • 1
  • Raanan Shamir
    • 1
  1. 1.Institute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of MedicineTel-Aviv UniversityTel AvivIsrael

Personalised recommendations