Infliximab therapy for pediatric Crohn's disease

Crohn's disease (CD) is a chronic inflammatory disease that may involve any part of the gastrointestinal tract, characterized by transmural intestinal lesion in a genetically susceptible host. Anti-TNF-alpha neutralising agent, infliximab, the chimeric monoclonal IgG1 antibody, is indicated for pediatric patients with CD and medically refractory luminal and fistulising disease. The present clinical practice for infliximab use is induction sequence of 5 mg/kg at 0, 2 and 6 weeks administered intravenously and followed by infusion every 8 weeks thereafter. Careful attention should be paid to the potential adverse events, especially infections and malignancy. Recently, fatal cases in young patients with hepatosplenic T-cell lymphoma treated with infliximab and concomitant purine analogs were reported. In this review the authors summarize the present knowledge of infliximab therapy in children with CD based on the available published literature.