Crohn's disease: current treatment options
1Department of Paediatric Gastroenterology, Central Manchester and Manchester Children's University Hospitals, Booth Hall Children's Hospital, Charlestown Road, Blackley, Manchester M9 7AA, UK. tony.akobeng@cmmc.nhs.uk
Archives of Disease in Childhood
|May 6, 2008
Summary
Exclusive enteral nutrition is the first-line treatment for inducing remission in pediatric Crohn
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Therapeutics
Background:
- Crohn's disease (CD) lacks a cure, necessitating effective management strategies.
- Understanding established and emerging treatments is crucial for improving pediatric CD patient quality of life.
Purpose of the Study:
- To provide an evidence-based overview of current medical treatments for inducing and maintaining remission in pediatric CD.
- To evaluate the efficacy of various therapeutic options for pediatric Crohn's disease.
Main Methods:
- Review of the evidence base for established and emerging CD treatments.
- Analysis of treatment efficacy for remission induction and maintenance in pediatric populations.
Main Results:
- Exclusive enteral nutrition is recommended for inducing remission in pediatric CD.
- Corticosteroids induce remission but have adverse events; immunosuppressants (azathioprine, methotrexate) benefit chronic cases.
- Anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents (infliximab, adalimumab) are effective for refractory or intolerant patients.
Conclusions:
- Exclusive enteral nutrition is the preferred initial therapy for remission induction in pediatric CD.
- Immunosuppressants and anti-TNF-alpha agents are key for maintaining remission, while corticosteroids and 5-aminosalicylates are not recommended for maintenance.
- Long-term enteral nutrition supplementation shows promise for maintaining remission in CD.
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