Infliximab, adalimumab, and certolizumab are monoclonal antibodies against tumor necrosis factor‐α (TNFα), a proinflammatory cytokine with an increased expression in the inflamed tissues of inflammatory bowel disease (IBD) patients. Currently, infliximab is the only anti‐TNF drug that has been approved for use in refractory pediatric Crohn's disease (CD). Nevertheless, adalimumab and certolizumab have been used off‐label to treat refractory pediatric IBD. Over the past 10 years, anti‐TNF treatment has been of great benefit to many pediatric IBD patients, but their use is not without risks (infections, autoimmune diseases, malignancies). Despite the growing experience with these drugs in children with IBD, optimal treatment strategies still need to be determined. The purpose of this review is to summarize the current knowledge on the use of anti‐TNF drugs in pediatric IBD and to discuss the yet‐unsolved issues. (Inflamm Bowel Dis 2011;)
1 Department of Pediatric Gastroenterology, Erasmus MC‐Sophia Children's Hospital, Rotterdam, the Netherlands
* Erasmus MC‐Sophia Children's Hospital, Pediatric Gastroenterology, Department of Pediatrics, Dr. Molewaterplein 60, 3015 GJ, Rotterdam, the Netherlands
Received 12 July 2011; Accepted 29 July 2011
Published online 20 September 2011 in Wiley Online Library (wileyonlinelibrary.com).
Conflict of interest: the second and last author have participated in the REACH study by inclusion of patients (initiated by Centocor). The company did not play any role in the writing of this article.