Infliximab in the treatment of pediatric Crohns disease

Tamara L Feldman and Joel R Rosh

Infliximab, a murine monoclonal antibody directed against TNF-α, has been approved for the induction and maintenance of remission in moderate-to-severe pediatric Crohn’s disease that is unresponsive to conventional therapy. Infl iximab is administered intravenously and can be infused over 2–3 h. The recommended induction dosing schedule consists of a series of three 5 mg/kg doses of infl iximab delivered at weeks 0, 2 and 6. Regularly scheduled maintenance therapy is recommended to be given every 8 weeks. While initially it was believed that the administration of concomitant immunomodulators would signifi cantly enhance the clinical effi cacy of infl iximab, recent data and safety concerns have called the benefi t of such a strategy into question. Currently, clinical research on the use of infl iximab in pediatric Crohn’s disease has focused on the unmet need of being able to identify which patients could benefi t most from infl iximab therapy.