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The Future of Advanced Therapies for Pediatric Crohn’s Disease

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Abstract

Pediatric Crohn’s disease commonly presents with moderate-to-severe intestinal inflammation with a greater risk of complications if remission is not achieved. Anti-tumor necrosis factor therapies have offered the possibility of deep and durable remission; however, many children do not respond or no longer respond over time. Further, some children do not require broader systemic immunosuppression to achieve remission and are better served by an alternative treatment strategy. Proper utilization of advanced biologic and small-molecule therapies, which have become available for adult patients since anti-tumor necrosis factor medications, is paramount for tighter disease control for a large proportion of children. Newer advanced therapies such as anti-integrin and anti-interleukin biologics, and several small-molecule agents capitalize on various mechanisms through narrower immunologic targets and reduced immunogenicity. Given limited regulatory approvals of these agents for use in children with Crohn’s disease, clinicians continue to rely on data extrapolated from clinical trials in adult patients, sparse pediatric studies, and a growing real-world experience for treatment selection and optimization. In this article, we discuss currently available treatment options, pipeline drugs, and relevant data as they pertain to some of the most pressing clinical challenges faced in treating pediatric Crohn’s disease.

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology, Liver Diseases, and Nutrition, Steven and Alexandra Cohen Children’s Medical Center, Northwell Health, 1991 Marcus Ave, Suite M100, New Hyde Park, NY, 11042, USA

    Julie Gallagher, Joel R. Rosh & Benjamin Sahn

  2. Feinstein Institutes for Medical Research, Manhasset, NY, USA

    Benjamin Sahn

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  1. Julie Gallagher
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Correspondence to Benjamin Sahn.

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Julie Gallagher, Joel R. Rosh, and Benjamin Sahn have no conflicts of interest that are directly related to the content of this article.

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JG: conceptualization: lead; methodology: lead; writing, original draft: lead; writing, review and editing: lead. JR: conceptualization: support; writing, original draft: support; writing, review and editing: support. BS: conceptualization: lead; supervision: lead; writing, original draft: support; writing, review and editing: support.

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Gallagher, J., Rosh, J.R. & Sahn, B. The Future of Advanced Therapies for Pediatric Crohn’s Disease. Pediatr Drugs 25, 621–633 (2023). https://doi.org/10.1007/s40272-023-00590-x

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