Infliximab therapy for pediatric crohn disease and ulcerative colitis

The inflammatory bowel diseases (IBDs), including Crohn disease and ulcerative colitis, are chronic inflammatory disorders of the gastrointestinal tract most often diagnosed in adolescence and young adulthood, with a rising incidence in pediatric populations. The goals of therapy of IBD in children consist of eliminating symptoms, normalizing quality of life, restoring growth, and preventing complications while minimizing the adverse effects of medications. These goals are often not achieved with conventional therapeutic strategies, and the use of biologic therapies, like anti-TNF agents, has increasingly become prevalent leading to significant improvement in outcomes and quality of life. Infliximab was the first anti-TNF agent to be approved for treatment of IBD. Their use, however, must be tempered with recognition of side effects, especially infections and malignancies. Emerging strategies to minimize loss of response with scheduled dosing and therapeutic drug monitoring are being employed to maintain long-term remission with these medications.