Golimumab Therapy in Six Patients with Severe Pediatric Onset Crohn's Disease.

Anti-TNF[alpha] blockade is so far the most effective therapy for extensive pediatric Crohn[Combining Acute Accent]s disease (CD), but loss of response is frequently encountered. We describe here the use of golimumab (Simponi) in six pediatric CD patients with antibody formation/loss of response to infliximab and adalimumab. Most patients had undergone surgery but had poor disease control. After introduction of golimumab, the levels of inflammatory markers and fecal calprotectin declined at first, but the response was not sustained. Each patient needed dose escalation of golimumab from 4 to 2 week intervals, in order to maintain response and to increase trough levels. Importantly, most patients were able to attend school when undergoing golimumab therapy. As with other anti-TNF[alpha] drugs, follow-up of drug levels is advisable. Although golimumab therapy failed in most patients, it is an alternate treatment option in pediatric patients with severe CD. The therapeutic response, however, is suboptimal in anti-TNF[alpha] exposed patients. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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