Treatment of chronic inflammatory intestinal diseases in children and adolescents. Therapy concepts including biologics

The treatment of children and adolescents with chronic inflammatory intestinal diseases is still problematic because of a narrow scientific basis for therapeutic decision-making. Data from studies involving adults must be evaluated with caution. Biologics, such as TNF-alpha blockers have been approved for the induction and maintenance of remission in moderate-to-severe pediatric Crohn's disease that is unresponsive to conventional therapy. Data from studies on children show a steroid-saving and growth optimizing effect. Regularly scheduled maintenance therapy is recommended. Inflixmab is also a therapeutic alternative in children with severe ulcerative colitis. Adalimumab may be used in cases of side-effects or loss of response.