Biologic Therapy Helps Fight Crohn's Disease.

• Position: Brief Article

Children suffering from active, severe Crohn's disease who had not responded to conventional therapy over four months and had not been able to taper off their potentially growth-stunting steroid therapy showed significant improvement and were able to decrease steroid usage within four weeks of an infusion of a new biologic therapy, infliximab. Crohn's disease is a chronic, debilitating, and relapsing disorder characterized by inflammatory destruction of the gastrointestinal tract, most commonly affecting the large and small bowel. About 400,000 Americans suffer from Crohn's disease, with symptoms including diarrhea, fever, abdominal pain, and weight loss. Up to 30% of patients develop fistulas--tunnel-like openings that burrow through the bowel wall into nearby organs or through the skin's surface. An estimated one in 800 U.S. children has the condition, usually presenting between 12 and 16 years of age.

The study by Medical College of Wisconsin, Milwaukee, researchers showed that children with early disease --up to two years from time of diagnosis--had a markedly prolonged response to the drug, compared with those who were diagnosed with Crohn's disease for longer than two years. No serious, clinically significant adverse effects were evident during the 12-month study of 15 pediatric patients at the hospital.

"Because Crohn's disease most frequently is diagnosed in adolescents and young adults, optimizing treatment in pediatric patients is crucial. We use corticosteroids to control inflammation, but when given on a long-term basis they can have serious side effects that are detrimental to physical and emotional development in adolescents," notes the study's lead investigator, Subra Kugathasan, assistant professor of pediatrics at the Medical College. "Early use of infliximab in steroid-dependent children may enable pediatricians to [taper] patients off steroids more quickly and may represent an optimal approach that is fast, effective, and, especially important in pediatric cases, less prone to significant...